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

Contract Number	41
Brand Code	4101A
Brand Name	ZOLENDRONIC ACID 4MG INJ (SLS) (BQ)
Active Ingredient	ZOLENDRONIC ACID
Trade Name	ZOLENDRONIC ACID
Package Size	4MG VIAL
Formulary Category	BQ
Pkg Price	30.42
Unit Price	30.418
Strength	4MG
Unit Description	VIAL
Max. Reimbursable Quantity / Month	2
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	2024-04-01
Drug Contract End Date	2024-05-27
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	9224
Therapeutic Desc	BONE RESORPTION INHIBITORS
Status Description
Default Route	IV
Max Repeats	6
Therapeutic Head	BONE RESORPTION INHIBITORS
Amend Date	2024-04-15