Drugs available on Contract - [HYDROXYCOBALAMINE 1MG/ML INJ (RTM/PHA) ], []

Contract Number	40
Brand Code	4811D
Brand Name	HYDROXYCOBALAMINE 1MG/ML INJ (RTM/PHA)
Active Ingredient	HYDROXYCOBALAMINE
Trade Name	HYDROXYCOBALAMINE
Package Size	10X1ML
Formulary Category	B
Pkg Price	14.90
Unit Price	1.49
Strength	1MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	RTM
Manufacturer Name	PANPHARMA GMBH
Agent Code	PHA
Agent Name	PHARMACY SALES CARIBBEAN
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	8808
Therapeutic Desc	VITAMIN B COMPLEX
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	VITAMINS
Amend Date