Drugs available on Contract - [AMINOCAPROIC ACID 250MG/ML INJ (SLS], []

Contract Number	42
Brand Code	10518
Brand Name	AMINOCAPROIC ACID 250MG/ML INJ (SLS
Active Ingredient	AMINOCAPROIC ACID
Trade Name	AMINOCAPROIC ACID
Package Size	20ML
Formulary Category	BQ
Pkg Price	20.25
Unit Price	20.25
Strength	250MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	10
Package Description	VIAL
Manufacturer Code	SLS
Manufacturer Name	SAMARTH LIFE SCIENCES
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	202816
Therapeutic Desc	HEMOSTATICS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	HEMOSTATICS
Amend Date