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

Contract Number	42
Brand Code	4811Q
Brand Name	HYDROXYCOBALAMINE 1MG/ML INJ (FSB)
Active Ingredient	HYDROXYCOBALAMINE
Trade Name	HYDROXYCOBALAMINE
Package Size	10X1ML
Formulary Category	B
Pkg Price	16.72
Unit Price	1.67
Strength	1MG/ML
Unit Description	AMPG
Max. Reimbursable Quantity / Month	3
Package Description
Manufacturer Code	FSB
Manufacturer Name	FLAGSHIP BIOTECH
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	8808
Therapeutic Desc	VITAMIN B COMPLEX
Status Description
Default Route	IM
Max Repeats	0
Therapeutic Head	VITAMIN B COMPLEX
Amend Date	2026-03-05