Contracted Products [ACYCLOVIR 5% OINT (TOR) ]

Contract Number	41
Brand Name	ACYCLOVIR 5% OINT (TOR)
Package Size	15G
Formulary Category	C
Unit Price	69.3173
Strength	5%
Max. Reimbursable / Month	2
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0