Displaying 2741 - 2760 of 5993
  • Print
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
42 4151L BROMOPRIN 2.5MG TAB (JLP) BROMOCRIPTINE BROMOCRIPTINE BROMOPRIN 100'S A 38.06 0.38 TAB 90 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 6834 OTHER CORPUS LUTEM HORMONES 2026-04-01 2028-03-31 ORAL 6 OTHER CORPUS LUTEM HORMONES
40 41811 MABTHERA 10MG/ML INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA 100MG VIAL C 1,391.78 1,391.78 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 41811 MABTHERA 10MG/ML INJ (ROC) RITUXIMAB (BQ) RITUXIMAB MABTHERA 100MG VIAL BQ 1391.78 1391.7819 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 41817 REMICADE 100MG INJ (JAC/STO) INFLIXIMAB INFLIXIMAB REMICADE 20ML VIAL C 1,460.17 1,460.17 INJECTION 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 41817 REMICADE 100MG INJ (JAC) INFLIXIMAB (C) INFLIXIMAB REMICADE 20ML VIAL C 1460.17 1460.1749 VIAL 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2024-04-01 2026-03-31 IV 0 DISEASE MODIFYING ANTIRHEUMATIC AGENTS
42 41817 REMICADE 100MG INJ (JAC) INFLIXIMAB INFLIXIMAB REMICADE 20ML VIAL BQ 1,460.18 1,460.17 VIAL 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2026-04-01 2028-03-31 IV 0 DISEASE MODIFYING ANTIRHEUMATIC AGENTS
40 4181A AVASTIN 25MG/ML INJ (ROC/AHI) BEVACIZUMAB BEVACIZUMAB AVASTIN 100MG VIAL C 1,003.06 1,003.06 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181A AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB (C) BEVACIZUMAB AVASTIN 100MG VIAL C 1003.06 1003.0616 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
42 4181A AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB BEVACIZUMAB AVASTIN 100MG VIAL C 1,003.06 1,003.06 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 2028-03-31 IV 0 ANTINEOPLASTICS
42 4181AM MABTHERA 10MG/ML INJ (ROC) RITUXIMAB RITUXIMAB MABTHERA 2X100MG BQ 1,252.60 1,252.60 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 2028-03-31 IV 0 ANTINEOPLASTICS
40 4181B AVASTIN 25MG/ML INJ (ROC/AHI) BEVACIZUMAB BEVACIZUMAB AVASTIN 400MG VIAL C 4,012.25 4,012.25 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181B AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB (C) BEVACIZUMAB AVASTIN 400MG VIAL C 4012.25 4012.2462 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
42 4181B AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB BEVACIZUMAB AVASTIN 400MG VIAL C 4,012.25 4,012.25 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 2028-03-31 IV 0 ANTINEOPLASTICS
40 4181BA REDITUX 10MG/ML INJ (DRL/AAL) RITUXIMAB RITUXIMAB REDITUX 50ML C 383.56 383.56 INJECTION 0 VIAL DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BB MABTHERA 10MG/ML INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA 50ML C 3,479.45 3,479.45 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181BB MABTHERA 10MG/ML INJ (ROC) RITUXIMA (BQ) RITUXIMAB MABTHERA 50ML BQ 3479.45 3479.4547 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 4181BC MABTHERA SC 1400MG INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA SC 11.7ML C 4,392.81 4,392.81 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181BC MABTHERA SC 1400MG INJ (ROC) RITUXIMAB (BQ) RITUXIMAB MABTHERA SC 11.7ML BQ 4392.81 4392.8116 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
42 4181BC MABTHERA SC 1400MG INJ (ROC) RITUXIMAB RITUXIMAB MABTHERA SC 11.7ML BQ 4,392.81 4,392.81 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 2028-03-31 IV 0 ANTINEOPLASTICS
40 4181BE KEYTRUDA 25MG/ML INJ (MSD/STO) PEMBROLIZUMAB PEMBROLIZUMAB KEYTRUDA 4ML VIAL C 9,766.50 9,766.50 INJECTION 0 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS