Drugs available on Contract - [CISPLATIN 1MG/ML INJ (DIL/AHI) ], []

Contract Number	40
Brand Code	7111R
Brand Name	CISPLATIN 1MG/ML INJ (DIL/AHI)
Active Ingredient	CISPLATIN
Trade Name	CISPLATIN
Package Size	50ML
Formulary Category	BQ
Pkg Price	18.02
Unit Price	18.02
Strength	1MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	DIL
Manufacturer Name	FRESENIUS KABI
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code	Anti-Neoplastic
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