Drugs available on Contract - [CHROMIUM 4MCG/ML INJ (KWA)], []

Contract Number	42
Brand Code	72713
Brand Name	CHROMIUM 4MCG/ML INJ (KWA)
Active Ingredient	CHROMIUM
Trade Name	CHROMIUM
Package Size	10ML
Formulary Category	BQ
Pkg Price	459.75
Unit Price	459.75
Strength	4MCG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	0
Package Description
Manufacturer Code	KWA
Manufacturer Name	KWALITY PHARMACEUTICALS
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	4012
Therapeutic Desc	REPLACEMENT THERAPY
Status Description	Add to Contract
Default Route	IV
Max Repeats	0
Therapeutic Head	REPLACEMENT THERAPY
Amend Date	2026-03-02