Drugs available on Contract - [POENTIMOL 0.5% EYE DR (LPO/COL) TIMOLOL], []

Contract Number	40
Brand Code	4073X
Brand Name	POENTIMOL 0.5% EYE DR (LPO/COL) TIMOLOL
Active Ingredient	TIMOLOL
Trade Name	POENTIMOL
Package Size	5ML
Formulary Category	C
Pkg Price	5.44
Unit Price	5.44
Strength	0.5%
Unit Description	EYE DROP
Max. Reimbursable Quantity / Month	0
Package Description	BOTT
Manufacturer Code	LPO
Manufacturer Name	LABORATORIOS POEN S.A.
Agent Code	COL
Agent Name	COLLINS LTD
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
Dentist Allowed	No
Therapeutic Code	524008
Therapeutic Desc	EENT BETA ADRENERGIC AGENTS
Status Description	Add to Contract as Cat C
Default Route	OPHTHALMIC
Max Repeats	0
Therapeutic Head	EYE, EAR, NOSE AND THROAT PREPARATIONS
Amend Date	2022-04-01