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

Contract Number	41
Brand Code	2161D
Brand Name	HYALURONIDASE 1500IU INJ (SLS (BQ)
Active Ingredient	HYALURONIDASE
Trade Name	HYALURONIDASE
Package Size	10X10ML
Formulary Category	BQ
Pkg Price	112.05
Unit Price	11.2049
Strength	1500IU
Unit Description	AMP
Max. Reimbursable Quantity / Month	0
Package Description	BOX
Manufacturer Code	SLS
Manufacturer Name	SAMARTH LIFE SCIENCES
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
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	4400
Therapeutic Desc	ENZYMES
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ENZYMES
Amend Date