Drugs available on Contract - [ENOXAPARIN 20MG INJ (GLN) (B)], []

Contract Number	41
Brand Code	A471R
Brand Name	ENOXAPARIN 20MG INJ (GLN) (B)
Active Ingredient	ENOXAPARIN
Trade Name	ENOXAPARIN
Package Size	2X20MG
Formulary Category	B
Pkg Price	11.82
Unit Price	5.9124
Strength	20MG
Unit Description	PFS
Max. Reimbursable Quantity / Month	30
Package Description	BOX
Manufacturer Code	GLN
Manufacturer Name	GLAND
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	20120416
Therapeutic Desc	HEPARINS
Status Description
Default Route	IV
Max Repeats	6
Therapeutic Head	HEPARINS
Amend Date