Drugs available on Contract - [ETOPOSIDE 20MG/ML INJ (INP/AHI) ], []

Contract Number	40
Brand Code	6781R
Brand Name	ETOPOSIDE 20MG/ML INJ (INP/AHI)
Active Ingredient	ETOPOSIDE
Trade Name	ETOPOSIDE
Package Size	5ML VIAL
Formulary Category	BQ
Pkg Price	17.21
Unit Price	17.21
Strength	20MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	INP
Manufacturer Name	INTAS PHARMACEUTICALS LTD
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE 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	0
Dentist Allowed	No
Therapeutic Code	1000
Therapeutic Desc	ANTINEOPLASTICS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ANTINEOPLASTICS
Amend Date