Drugs available on Contract - [NEXIUM 10MG GRAN (AZN) ESOMEPRAZOLE], []

Contract Number	42
Brand Code	B041LE
Brand Name	NEXIUM 10MG GRAN (AZN) ESOMEPRAZOLE
Active Ingredient	ESOMEPRAZOLE
Trade Name	NEXIUM
Package Size	28'S
Formulary Category	C
Pkg Price	47.84
Unit Price	1.71
Strength	10MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	0
Package Description	BLIS
Manufacturer Code	AZN
Manufacturer Name	ASTRAZENECA AB
Agent Code	COL
Agent Name	AVENTA BARBADOS
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	562836
Therapeutic Desc	PROTON PUMP INHIBITORS
Status Description
Default Route	ORAL
Max Repeats	0
Therapeutic Head	PROTON PUMP INHIBITORS
Amend Date