Drugs available on Contract - [FURASONE 0.1% CR (CAR) MOMETASONE], []

Contract Number	41
Brand Code	3301AJ
Brand Name	FURASONE 0.1% CR (CAR) MOMETASONE
Active Ingredient	MOMETASONE
Trade Name	FURASONE
Package Size	15G
Formulary Category	A
Pkg Price	6.2
Unit Price	6.1978
Strength	0.1%
Unit Description	TUBE
Max. Reimbursable Quantity / Month	2
Package Description	BOX
Manufacturer Code	CAR
Manufacturer Name	CARLISLE LABORATORIES LTD
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	APPLY OD
SIGFactor	1
Dentist Allowed	N
Therapeutic Code	8406
Therapeutic Desc	ANTI-INFLAMMATORY AGENTS, TOPICAL
Status Description
Default Route	TOPICAL
Max Repeats	0
Therapeutic Head	ANTI-INFLAMMATORY AGENTS, TOPICAL
Amend Date