Drugs available on Contract - [VANCOMYCIN 1G INJ (KWA) (BQ)], []

Contract Number	41
Brand Code	42931
Brand Name	VANCOMYCIN 1G INJ (KWA) (BQ)
Active Ingredient	VANCOMYCIN
Trade Name	VANCOMYCIN
Package Size	1G VIAL
Formulary Category	BQ
Pkg Price	10.85
Unit Price	10.85
Strength	1G
Unit Description	VIAL
Max. Reimbursable Quantity / Month	28
Package Description	VIAL
Manufacturer Code	KWA
Manufacturer Name	KWALITY PHARMACEUTICALS
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-05-25
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	08122816
Therapeutic Desc	GLYCOPEPTIDES
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	GLYCOPEPTIDES
Amend Date	2024-05-24