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

Contract Number	41
Brand Code	2592AJ
Brand Name	LADINE 10MG/ML INJ (LDP) FAMOTIDINE
Active Ingredient	FAMOTIDINE
Trade Name	LADINE
Package Size	10X2ML
Formulary Category	B
Pkg Price	52.03
Unit Price	5.2029
Strength	10MG/ML
Unit Description	AMP
Max. Reimbursable Quantity / Month	0
Package Description	BOX
Manufacturer Code	LDP
Manufacturer Name	LABDHI PHARMA
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
Dentist Allowed	N
Therapeutic Code	562812
Therapeutic Desc	HISTAMINE RECEPTOR ANTAGONIST
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	HISTAMINE RECEPTOR ANTAGONIST
Amend Date