Drugs available on Contract - [DRYLIEF 1% EYE DR (ARP) CARBOXYMETH], []

Contract Number	41
Brand Code	4701AY
Brand Name	DRYLIEF 1% EYE DR (ARP) CARBOXYMETH
Active Ingredient	CARBOXYMETHYLCELLULOSE
Trade Name	DRYLIEF
Package Size	10ML
Formulary Category	A
Pkg Price	6.82
Unit Price	6.823
Strength	1%
Unit Description	BOTT
Max. Reimbursable Quantity / Month	1
Package Description	BOTT
Manufacturer Code	ARP
Manufacturer Name	ARISTOPHARMA LTD
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	5292
Therapeutic Desc	EENT DRUGS MISCELLANEOPUS
Status Description
Default Route	OPHTHALMIC
Max Repeats	6
Therapeutic Head	EENT DRUGS MISCELLANEOPUS
Amend Date