Drugs available on Contract - [CEFAZOLIN 1G IV/IM INJ (RTM) (BQ)], []

Contract Number	41
Brand Code	01133
Brand Name	CEFAZOLIN 1G IV/IM INJ (RTM) (BQ)
Active Ingredient	CEFAZOLIN
Trade Name	CEFAZOLIN
Package Size	1G VIAL
Formulary Category	BQ
Pkg Price	3.97
Unit Price	3.9688
Strength	1G IV/IM
Unit Description	VIAL
Max. Reimbursable Quantity / Month	10
Package Description	VIAL
Manufacturer Code	RTM
Manufacturer Name	PANPHARMA GMBH
Agent Code	PHA
Agent Name	PHARMACY SALES CARIBBEAN
Benefit
Benefit Cat Code	15
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	08120604
Therapeutic Desc	FIRST GEN CEPHALOSPORINS
Status Description
Default Route	IV/IM
Max Repeats	0
Therapeutic Head	FIRST GEN CEPHALOSPORINS
Amend Date