Drugs available on Contract - [HYALURONIDASE 1500IU INJ (SLS/AHI)], []

Contract Number	40
Brand Code	2161D
Brand Name	HYALURONIDASE 1500IU INJ (SLS/AHI)
Active Ingredient	HYALURONIDASE
Trade Name	HYALURONIDASE
Package Size	10X10ML
Formulary Category	BQ
Pkg Price	111.94
Unit Price	11.19
Strength	1500IU
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	SLS
Manufacturer Name	SAMARTH LIFE SCIENCES
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
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	0
Dentist Allowed	No
Therapeutic Code	4400
Therapeutic Desc	ENZYMES
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ENZYMES
Amend Date