Drugs available on Contract - [BIOGLANDIN 500MCG/ML INJ (UBI/RXP) ALPROSTADI], []

Contract Number	40
Brand Code	A1917
Brand Name	BIOGLANDIN 500MCG/ML INJ (UBI/RXP) ALPROSTADI
Active Ingredient	ALPROSTADIL
Trade Name	BIOGLANDIN
Package Size	1ML AMP
Formulary Category	BQ
Pkg Price	237.85
Unit Price	237.85
Strength	500MCG/ML
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	AMP
Manufacturer Code	UBI
Manufacturer Name	UNITED BIOTECH (P) LIMITED
Agent Code	RXP
Agent Name	RX PRO INC
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	241292
Therapeutic Desc	VASODILATING AGENTS, MISCELLANEOUS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	CARDIOVASCULAR DRUGS
Amend Date