Drugs available on Contract - [PANTOPRAZOLE 40MG INJ (CIP/AHI) ], []

Contract Number	40
Brand Code	B0427
Brand Name	PANTOPRAZOLE 40MG INJ (CIP/AHI)
Active Ingredient	PANTOPRAZOLE
Trade Name	PANTOPRAZOLE
Package Size	40MG VIAL
Formulary Category	B
Pkg Price	2.61
Unit Price	2.61
Strength	40MG
Unit Description	INJECTION
Max. Reimbursable Quantity / Month	0
Package Description	VIAL
Manufacturer Code	CIP
Manufacturer Name	CIPLA LTD
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2022-09-30
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor
Dentist Allowed	No
Therapeutic Code	562836
Therapeutic Desc	PROTON PUMP INHIBITORS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	GASTROINTESTINAL DRUGS
Amend Date	2022-03-29