Drugs available on Contract - [FML LIQUIFILM 0.1% EYE DR (ALL) FLUOROME], []

Contract Number	42
Brand Code	A2712
Brand Name	FML LIQUIFILM 0.1% EYE DR (ALL) FLUOROME
Active Ingredient	FLUOROMETHOLONE
Trade Name	FML LIQUIFILM
Package Size	5ML
Formulary Category	C
Pkg Price	17.67
Unit Price	17.67
Strength	0.1%
Unit Description	BOTT
Max. Reimbursable Quantity / Month	0
Package Description	BOTT
Manufacturer Code	ALL
Manufacturer Name	ALLERGAN INTERNATIONAL
Agent Code	COL
Agent Name	AVENTA BARBADOS
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	5208
Therapeutic Desc	EENT ANTI-INFLAMMATORY AGENTS
Status Description
Default Route	OPHTHALMIC
Max Repeats	0
Therapeutic Head	EENT ANTI-INFLAMMATORY AGENTS
Amend Date