Drugs available on Contract - [HYDROCORTISONE 10MG TAB (SLS/AHI) ], []

Contract Number	40
Brand Code	26818
Brand Name	HYDROCORTISONE 10MG TAB (SLS/AHI)
Active Ingredient	HYDROCORTISONE
Trade Name	HYDROCORTISONE
Package Size	200'S
Formulary Category	A
Pkg Price	150.51
Unit Price	0.75
Strength	10MG
Unit Description	TABLET
Max. Reimbursable Quantity / Month	120
Package Description	TAB
Manufacturer Code	SLS
Manufacturer Name	SAMARTH LIFE SCIENCES
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	0
Dentist Allowed	No
Therapeutic Code	6804
Therapeutic Desc	ADRENALS
Status Description
Default Route	Oral
Max Repeats	6
Therapeutic Head	HORMONES AND SYNTHETIC SUBSTITUTES
Amend Date