Drugs available on Contract - [SAIZEN 6MG INJ (MEK/COL) SOMATROPIN], []

Contract Number	40
Brand Code	A3131
Brand Name	SAIZEN 6MG INJ (MEK/COL) SOMATROPIN
Active Ingredient	SOMATROPIN
Trade Name	SAIZEN
Package Size	VIAL
Formulary Category	C
Pkg Price	247.10
Unit Price	247.10
Strength	6MG
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	MEK
Manufacturer Name	MERCK SERONO
Agent Code	COL
Agent Name	COLLINS LTD
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	0
Dentist Allowed	No
Therapeutic Code	683004
Therapeutic Desc	SOMATROPHIN AGONIST
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	HORMONES AND SYNTHETIC SUBSTITUTES
Amend Date