Drugs available on Contract - [HYDRALLAZINE 20MG/ML INJ (FSB) (B)], []

Contract Number	41
Brand Code	11637
Brand Name	HYDRALLAZINE 20MG/ML INJ (FSB) (B)
Active Ingredient	HYDRALLAZINE
Trade Name	HYDRALLAZINE
Package Size	20MG VIAL
Formulary Category	B
Pkg Price	38.11
Unit Price	38.1109
Strength	20MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	FSB
Manufacturer Name	FLAGSHIP BIOTECH
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	240820
Therapeutic Desc	DIRECT VASODILATOR
Status Description
Default Route
Max Repeats	0
Therapeutic Head	DIRECT VASODILATOR
Amend Date