Drugs available on Contract - [ZOLENDRONIC ACID 4MG INJ (SLS/AHI) ], []

Contract Number	40
Brand Code	4101A
Brand Name	ZOLENDRONIC ACID 4MG INJ (SLS/AHI)
Active Ingredient	ZOLENDRONIC ACID
Trade Name	ZOLENDRONIC ACID
Package Size	4MG VIAL
Formulary Category	BQ
Pkg Price	38.95
Unit Price	38.95
Strength	4MG
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	SLS
Manufacturer Name	SAMARTH LIFE SCIENCES
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2022-09-30
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	No
Therapeutic Code	9224
Therapeutic Desc	BONE RESORPTION INHIBITORS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	UNCLASSIFIED THERAPEUTIC AGENTS
Amend Date	2022-03-29