Drugs available on Contract - [HYDROCORTISONE 10MG TAB (TEV) ], []

Contract Number	41
Brand Code	2681A
Brand Name	HYDROCORTISONE 10MG TAB (TEV)
Active Ingredient	HYDROCORTISONE
Trade Name	HYDROCORTISONE
Package Size	30'S
Formulary Category	A
Pkg Price	17.59
Unit Price	0.5863
Strength	10MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	120
Package Description	BOTT
Manufacturer Code	TEV
Manufacturer Name	TEVA UK LTD.
Agent Code	COL
Agent Name	COLLINS LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-12-17
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	6804
Therapeutic Desc	ADRENALS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	ADRENALS
Amend Date	2024-11-26