Drugs available on Contract - [NEBIDO 250MG/ML INJ (BSP/COL) TESTOSTERONE], []

Contract Number	40
Brand Code	50831
Brand Name	NEBIDO 250MG/ML INJ (BSP/COL) TESTOSTERONE
Active Ingredient	TESTOSTERONE
Trade Name	NEBIDO
Package Size	4ML VIAL
Formulary Category	BQ
Pkg Price	108.73
Unit Price	108.73
Strength	250MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	BSP
Manufacturer Name	BAYER SCHERING PHARMA AG.
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	1
Dentist Allowed	No
Therapeutic Code	6808
Therapeutic Desc	ANDROGENS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	HORMONES AND SYNTHETIC SUBSTITUTES
Amend Date