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

Contract Number	42
Brand Code	B0427
Brand Name	PANTOPRAZOLE 40MG INJ (CIP)
Active Ingredient	PANTOPRAZOLE
Trade Name	PANTOPRAZOLE
Package Size	40MG VIAL
Formulary Category	B
Pkg Price	1.55
Unit Price	1.55
Strength	40MG
Unit Description	VIAL
Max. Reimbursable Quantity / Month	7
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	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	562836
Therapeutic Desc	PROTON PUMP INHIBITORS
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	PROTON PUMP INHIBITORS
Amend Date