Drugs available on Contract - [LASIX 10MG/ML INJ (SFA) FRUSEMIDE], []

Contract Number	42
Brand Code	21322
Brand Name	LASIX 10MG/ML INJ (SFA) FRUSEMIDE
Active Ingredient	FRUSEMIDE
Trade Name	LASIX
Package Size	5X2ML
Formulary Category	B
Pkg Price	27.18
Unit Price	5.44
Strength	10MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	SFA
Manufacturer Name	SANOFI
Agent Code	COL
Agent Name	AVENTA BARBADOS
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	402808
Therapeutic Desc	LOOP DIURETICS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	LOOP DIURETICS
Amend Date