Drugs available on Contract - [ACETYLCYSTEINE 20% SOLN (DIL/AHI) ], []

Contract Number	40
Brand Code	4222G
Brand Name	ACETYLCYSTEINE 20% SOLN (DIL/AHI)
Active Ingredient	ACETYLCYSTEINE
Trade Name	ACETYLCYSTEINE
Package Size	3X30ML
Formulary Category	BQ
Pkg Price	273.82
Unit Price	91.27
Strength	20%
Unit Description	SOLUTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	DIL
Manufacturer Name	FRESENIUS KABI
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	No
Therapeutic Code	9212
Therapeutic Desc	ANTIDOTES
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	UNCLASSIFIED THERAPEUTIC AGENTS
Amend Date