Contracted Products [CYCLOVAX 5% CR (REM/SBI) ACYCLOVIR]

Contract Number	40
Brand Name	CYCLOVAX 5% CR (REM/SBI) ACYCLOVIR
Package Size	10G
Formulary Category	A
Unit Price	3.07
Strength	5%
Max. Reimbursable / Month	2
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0