Drugs available on Contract - [HYRIMOZ 40MG INJ (BCH) ADALIMUMAB (C)], []

Contract Number	41
Brand Code	31716
Brand Name	HYRIMOZ 40MG INJ (BCH) ADALIMUMAB (C)
Active Ingredient	ADALIMUMAB
Trade Name	HYRIMOZ
Package Size	2X40MG
Formulary Category	C
Pkg Price	1202.04
Unit Price	601.0214
Strength	40MG
Unit Description	BOX
Max. Reimbursable Quantity / Month	0
Package Description	PFS
Manufacturer Code	BCH
Manufacturer Name	SANDOZ
Agent Code	COL
Agent Name	COLLINS LTD
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	9236
Therapeutic Desc	DISEASE MODIFYING ANTIRHEUMATIC AGENTS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	DISEASE MODIFYING ANTIRHEUMATIC AGENTS
Amend Date