Drugs available on Contract - [PHENYLEPHRINE 10MG/ML INJ (MTP)], []

Contract Number	42
Brand Code	2353G
Brand Name	PHENYLEPHRINE 10MG/ML INJ (MTP)
Active Ingredient	PHENYLEPHRINE
Trade Name	PHENYLEPHRINE
Package Size	10X1ML
Formulary Category	B
Pkg Price	114.74
Unit Price	11.47
Strength	10MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	MTP
Manufacturer Name	MARTINDALE PHARMACEUTICALS
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
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	121204
Therapeutic Desc	ALPHA ADRENERGIC AGONIST
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ALPHA ADRENERGIC AGONIST
Amend Date