Drugs available on Contract - [MIDAZOLAM 5MG/ML INJ (RTM/PHA) ], []

Contract Number	40
Brand Code	6211D
Brand Name	MIDAZOLAM 5MG/ML INJ (RTM/PHA)
Active Ingredient	MIDAZOLAM
Trade Name	MIDAZOLAM
Package Size	10X3ML
Formulary Category	B
Pkg Price	$36.50
Unit Price	2.62
Strength	5MG/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	10
Dentist Allowed	No
Therapeutic Code	282408
Therapeutic Desc	BENZODIAZEPINES (SEDATIVES)
Status Description	PRICE CHANGE
Default Route	IV
Max Repeats	0
Therapeutic Head	CENTRAL NERVOUS SYSTEM DRUGS
Amend Date	0000-00-00