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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 A151A ADENOSINE 3MG/ML INJ (KWA/ATB) ADENOSINE ADENOSINE 10X2ML BQ 47.57 4.76 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
41 A151F ADENOSINE 3MG/ML INJ (LDP) (BQ) ADENOSINE ADENOSINE 10X2ML BQ 51.38 5.1376 VIAL 30 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 IV 0 ANTIARRHYTHMIC AGENTS
40 A151H ADENOSINE 3MG/ML INJ (MON/PHA) ADENOSINE ADENOSINE 10X2ML BQ 52.14 5.21 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS