Drugs available on Contract - [FLUPENTHIXOL 20MG/ML INJ (CIR) ], []

Contract Number	41
Brand Code	7471AB
Brand Name	FLUPENTHIXOL 20MG/ML INJ (CIR)
Active Ingredient	FLUPENTHIXOL
Trade Name	FLUPENTHIXOL
Package Size	10X1ML
Formulary Category	B
Pkg Price	85.63
Unit Price	8.563
Strength	20MG/ML
Unit Description	AMP
Max. Reimbursable Quantity / Month	6
Package Description	BOX
Manufacturer Code	CIR
Manufacturer Name	CIRON PHARMA
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	28160824
Therapeutic Desc	PHENOTHIAZINES
Status Description
Default Route	IM
Max Repeats	6
Therapeutic Head	PHENOTHIAZINES
Amend Date	2024-03-11