Drugs available on Contract - [DOPAMINE 40MG/ML INJ (MON/PHA) ], []

Contract Number	40
Brand Code	0801U
Brand Name	DOPAMINE 40MG/ML INJ (MON/PHA)
Active Ingredient	DOPAMINE
Trade Name	DOPAMINE
Package Size	5X5ML
Formulary Category	B
Pkg Price	8.02
Unit Price	1.60
Strength	40MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	MON
Manufacturer Name	MONTAGE PHARMACEUTICALS
Agent Code	PHA
Agent Name	PHARMACY SALES CARIBBEAN
Benefit
Benefit Cat Code
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor
Dentist Allowed	No
Therapeutic Code	121208
Therapeutic Desc	BETA ADRENERGIC AGONIST
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	AUTONOMIC DRUGS
Amend Date