Drugs available on Contract - [LORAZEPAM 2MG/ML INJ (FSB/ATB) ], []

Contract Number	40
Brand Code	4622U
Brand Name	LORAZEPAM 2MG/ML INJ (FSB/ATB)
Active Ingredient	LORAZEPAM
Trade Name	LORAZEPAM
Package Size	1ML VIAL
Formulary Category	B
Pkg Price	4.02
Unit Price	4.02
Strength	2MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	FSB
Manufacturer Name	FLAGSHIP BIOTECH
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2022-05-27
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	No
Therapeutic Code	282408
Therapeutic Desc	BENZODIAZEPINES (SEDATIVES)
Status Description	Price Change
Default Route	IV
Max Repeats	0
Therapeutic Head	CENTRAL NERVOUS SYSTEM DRUGS
Amend Date	2022-05-27