Drugs available on Contract - [ADENOSINE 3MG/ML INJ (MON/PHA) ], []

Contract Number	40
Brand Code	A151H
Brand Name	ADENOSINE 3MG/ML INJ (MON/PHA)
Active Ingredient	ADENOSINE
Trade Name	ADENOSINE
Package Size	10X2ML
Formulary Category	BQ
Pkg Price	52.14
Unit Price	5.21
Strength	3MG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	MON
Manufacturer Name	MONTAGE PHARMACEUTICALS
Agent Code	PHA
Agent Name	PHARMACY SALES CARIBBEAN
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
Dentist Allowed	No
Therapeutic Code	240404
Therapeutic Desc	ANTIARRHYTHMIC AGENTS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	CARDIOVASCULAR DRUGS
Amend Date