Drugs available on Contract - [FAMOTIDINE 10MG/ML INJ (DIL/AHI) ], []

Contract Number	40
Brand Code	2592AD
Brand Name	FAMOTIDINE 10MG/ML INJ (DIL/AHI)
Active Ingredient	FAMOTIDINE
Trade Name	FAMOTIDINE
Package Size	25X2ML
Formulary Category	B
Pkg Price	120.97
Unit Price	4.84
Strength	10MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	DIL
Manufacturer Name	FRESENIUS KABI
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
Dentist Allowed	No
Therapeutic Code	562812
Therapeutic Desc	HISTAMINE RECEPTOR ANTAGONIST
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	GASTROINTESTINAL DRUGS
Amend Date