Drugs available on Contract - [IDEW-FLO 1MG STRP (ENT) FLUORESCEIN], []

Contract Number	41
Brand Code	2401A
Brand Name	IDEW-FLO 1MG STRP (ENT) FLUORESCEIN
Active Ingredient	FLUORESCEIN
Trade Name	IDEW-FLO
Package Size	100'S
Formulary Category	B
Pkg Price	22.698
Unit Price	0.227
Strength	1MG
Unit Description	STRP
Max. Reimbursable Quantity / Month	0
Package Description	BOX
Manufacturer Code	ENT
Manufacturer Name	ENTOD
Agent Code	PHA
Agent Name	PHARMACY SALES CARIBBEAN
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	5236
Therapeutic Desc	EENT UNCLASSIFIED
Status Description
Default Route	TOPICAL
Max Repeats	0
Therapeutic Head	EENT UNCLASSIFIED
Amend Date