Drugs available on Contract - [TROPICAMIDE 1% EYE DR (AKI) ], []

Contract Number	41
Brand Code	2362J
Brand Name	TROPICAMIDE 1% EYE DR (AKI)
Active Ingredient	TROPICAMIDE
Trade Name	TROPICAMIDE
Package Size	15ML
Formulary Category	A
Pkg Price	44.06
Unit Price	44.064
Strength	1%
Unit Description	BOTT
Max. Reimbursable Quantity / Month	1
Package Description	BOTT
Manufacturer Code	AKI
Manufacturer Name	AKORN INC.
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	5224
Therapeutic Desc	EENT MYDRIATICS
Status Description
Default Route	OPHTHALMIC
Max Repeats	0
Therapeutic Head	EENT MYDRIATICS
Amend Date