Drugs available on Contract - [ERYTHROMYCIN 500MG INJ (CIR/AHI) ], []

Contract Number	40
Brand Code	4021E
Brand Name	ERYTHROMYCIN 500MG INJ (CIR/AHI)
Active Ingredient	ERYTHROMYCIN LACTOBIONATE
Trade Name	ERYTHROMYCIN
Package Size	500MG VIAL
Formulary Category	BQ
Pkg Price	28.92
Unit Price	28.92
Strength	500MG
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	Yes
Therapeutic Code	08121204
Therapeutic Desc	ERYTHROMYCINS
Status Description
Default Route	IV
Max Repeats	6
Therapeutic Head	ANTI-INFECTIVE AGENTS
Amend Date