Drugs available on Contract - [GALVUS 50MG TAB (NVS) VILDAGLIPTIN], []

Contract Number	42
Brand Code	B2712
Brand Name	GALVUS 50MG TAB (NVS) VILDAGLIPTIN
Active Ingredient	VILDAGLIPTIN
Trade Name	GALVUS
Package Size	56'S
Formulary Category	C
Pkg Price	27.18
Unit Price	0.49
Strength	50MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	60
Package Description	BLIS
Manufacturer Code	NVS
Manufacturer Name	NOVARTIS CARIBE SA
Agent Code	COL
Agent Name	AVENTA BARBADOS
Benefit	B
Benefit Cat Code	Anti-Diabetic
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	682005
Therapeutic Desc	DIPEPTIDYL PEPTIDASE INHIBITORS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	DIPEPTIDYL PEPTIDASE INHIBITORS
Amend Date