Drugs available on Contract - [DROPSTAR 0.4% EYE DR (LPO/COL) SOD. HYALURONA], []

Contract Number	40
Brand Code	4701F
Brand Name	DROPSTAR 0.4% EYE DR (LPO/COL) SOD. HYALURONA
Active Ingredient	SODIUM HYALURONATE
Trade Name	DROPSTAR
Package Size	10ML
Formulary Category	A
Pkg Price	7.61
Unit Price	7.61
Strength	0.4%
Unit Description	EYE DROP
Max. Reimbursable Quantity / Month	1
Package Description	BOTT
Manufacturer Code	LPO
Manufacturer Name	LABORATORIOS POEN S.A.
Agent Code	COL
Agent Name	COLLINS LTD
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
Dentist Allowed	No
Therapeutic Code	5292
Therapeutic Desc	EENT DRUGS MISCELLANEOPUS
Status Description
Default Route	OPHTHALMIC
Max Repeats	6
Therapeutic Head	EYE, EAR, NOSE AND THROAT PREPARATIONS
Amend Date