Drugs available on Contract - [AMLOTENSIVE CT 5MG|25MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE], []

Contract Number	42
Brand Code	B5911
Brand Name	AMLOTENSIVE CT 5MG\|25MG TAB (CAR) AMLODIPINE\|CHLORTHALIDONE
Active Ingredient	AMLODIPINE\|CHLORTHALIDONE
Trade Name	AMLOTENSIVE CT
Package Size	210'S
Formulary Category	A
Pkg Price	26.26
Unit Price	0.13
Strength	5MG\|25MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	60
Package Description	BOTT
Manufacturer Code	CAR
Manufacturer Name	CARLISLE LABORATORIES LTD
Agent Code	COL
Agent Name	AVENTA BARBADOS
Benefit	B
Benefit Cat Code	Anti-Hypertensive
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	242892
Therapeutic Desc	CCBs, MISCELLANEOUS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	CCBs, MISCELLANEOUS
Amend Date