Drugs available on Contract - [DOXYCYCLINE 100MG INJ (KWA) (B)], []

Contract Number	41
Brand Code	5522D
Brand Name	DOXYCYCLINE 100MG INJ (KWA) (B)
Active Ingredient	DOXYCYCLINE
Trade Name	DOXYCYCLINE
Package Size	100MG VIAL
Formulary Category	B
Pkg Price	26.34
Unit Price	26.3406
Strength	100MG
Unit Description	VIAL
Max. Reimbursable Quantity / Month	28
Package Description	VIAL
Manufacturer Code	KWA
Manufacturer Name	KWALITY PHARMACEUTICALS
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS LTD
Benefit
Benefit Cat Code	15
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	Y
Therapeutic Code	081224
Therapeutic Desc	TETRACYCLINES
Status Description
Default Route	IV
Max Repeats	1
Therapeutic Head	TETRACYCLINES
Amend Date