Drugs available on Contract - [LAVIT-6 50MG TAB (LDP) PYRIDOXINE], []

Contract Number	41
Brand Code	34915
Brand Name	LAVIT-6 50MG TAB (LDP) PYRIDOXINE
Active Ingredient	PYRIDOXINE
Trade Name	LAVIT-6
Package Size	100'S
Formulary Category	B
Pkg Price	17.75
Unit Price	0.1775
Strength	50MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	150
Package Description	BOX
Manufacturer Code	LDP
Manufacturer Name	LABDHI PHARMA
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
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	0
Dentist Allowed	N
Therapeutic Code	8808
Therapeutic Desc	VITAMIN B COMPLEX
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	VITAMIN B COMPLEX
Amend Date