Drugs available on Contract - [MEXAPRIN 40MG INJ (GLN) ENOXAPARIN], []

Contract Number	42
Brand Code	A472X
Brand Name	MEXAPRIN 40MG INJ (GLN) ENOXAPARIN
Active Ingredient	ENOXAPARIN
Trade Name	MEXAPRIN
Package Size	2X40MG
Formulary Category	B
Pkg Price	18.70
Unit Price	9.35
Strength	40MG
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	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	20120416
Therapeutic Desc	HEPARINS
Status Description
Default Route	IV
Max Repeats	6
Therapeutic Head	HEPARINS
Amend Date