Drugs available on Contract - [GLUGON 1MG INJ (KWL/RXP) GLUCAGON], []

Contract Number	40
Brand Code	48916
Brand Name	GLUGON 1MG INJ (KWL/RXP) GLUCAGON
Active Ingredient	GLUCAGON
Trade Name	GLUGON
Package Size	1MG AMP
Formulary Category	B
Pkg Price	103.30
Unit Price	103.30
Strength	1MG
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	KWL
Manufacturer Name	KHANDELWAL LABS
Agent Code	RXP
Agent Name	RX PRO INC
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	6822
Therapeutic Desc	ANTIHYPOGLYCEMIC AGENTS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	HORMONES AND SYNTHETIC SUBSTITUTES
Amend Date