Drugs available on Contract - [HYDROCORTISONE SOD SUCC 100MG INJ (CIR/AHI) ], []

Contract Number	40
Brand Code	2691AA
Brand Name	HYDROCORTISONE SOD SUCC 100MG INJ (CIR/AHI)
Active Ingredient	HYDROCORTISONE SODIUM SUCCINATE
Trade Name	HYDROCORTISONE SOD SUCC
Package Size	100MG VIAL
Formulary Category	B
Pkg Price	1.98
Unit Price	1.98
Strength	100MG
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	CIR
Manufacturer Name	CIRON PHARMA
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	IV
Max Repeats	0
Therapeutic Head	HORMONES AND SYNTHETIC SUBSTITUTES
Amend Date