Contracted Products [CYCLOVAX 800MG TAB (REM) ACYCLOVIR]

Contract Number	41
Brand Name	CYCLOVAX 800MG TAB (REM) ACYCLOVIR
Package Size	1x10
Formulary Category	A
Unit Price	0.6497
Strength	800MG
Max. Reimbursable / Month	50
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