Drugs available on Contract - [CARBOPLATIN 150MG INJ (FSB)], []

Contract Number	42
Brand Code	7091V
Brand Name	CARBOPLATIN 150MG INJ (FSB)
Active Ingredient	CARBOPLATIN
Trade Name	CARBOPLATIN
Package Size	150MG VIAL
Formulary Category	BQ
Pkg Price	33.44
Unit Price	33.44
Strength	150MG
Unit Description	VIAL
Max. Reimbursable Quantity / Month	10
Package Description
Manufacturer Code	FSB
Manufacturer Name	FLAGSHIP BIOTECH
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code	Anti-Neoplastic
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	1000
Therapeutic Desc	ANTINEOPLASTICS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	ANTINEOPLASTICS
Amend Date	2026-03-05