Drugs available on Contract - [AMLOTENSIVE CT 10MG|25MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE], []

Contract Number	41
Brand Code	B5931
Brand Name	AMLOTENSIVE CT 10MG\|25MG TAB (CAR) AMLODIPINE\|CHLORTHALIDONE
Active Ingredient	AMLODIPINE\|CHLORTHALIDONE
Trade Name	AMLOTENSIVE CT
Package Size	210'S
Formulary Category	A
Pkg Price	26.259
Unit Price	0.125
Strength	10MG\|25MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	30
Package Description	BOX
Manufacturer Code	CAR
Manufacturer Name	CARLISLE LABORATORIES LTD
Agent Code	COL
Agent Name	COLLINS LTD
Benefit	B
Benefit Cat Code	Anti-Hypertensive
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	9244
Therapeutic Desc	IMMUNOSUPPRESSIVE AGENTS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	IMMUNOSUPPRESSIVE AGENTS
Amend Date