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

Contract Number	41
Brand Name	CYCLOVAX 5% CR (REM) ACYCLOVIR
Package Size	10G
Formulary Category	A
Unit Price	3.0717
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