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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
40 05216 ACTINOMYCIN D 500MCG INJ (KWA/ATB) ACTINOMYCIN D ACTINOMYCIN D 500MCG VIA BQ 36.70 36.70 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 05217 DACTINOTEC 500MCG INJ (UBI/RXP) ACTINOMYCIN D ACTINOMYCIN D DACTINOTEC 500MCG BQ 31.26 31.26 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 05218 ACTINOMYCIN D 500MCG INJ (CHC/ATB) ACTINOMYCIN D ACTINOMYCIN D 500MCG VIA BQ 33.16 33.16 INJECTION 0 VIAL CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 05219 ACTINOMYCIN D 500MCG INJ (ZUV) (BQ) ACTINOMYCIN D ACTINOMYCIN 500MCG BQ 14.71 14.7061 VIAL 10 VIAL ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS