Displaying 1 - 10 of 10
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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 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
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
40 4181BH BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB BEVACIZUMAB BEMABIX 4ML VIAL C 856.27 856.27 INJECTION 0 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BH BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB (C) BEVACIZUMAB BEMABIX 4ML VIAL C 856.27 856.27 INJECTION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2022-04-01 2023-04-18 Delete from contract IV 0 ANTINEOPLASTICS 2023-03-07
40 4181BJ BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB BEVACIZUMAB BEMABIX 16ML VIAL C 3,811.28 3,811.28 INJECTION 0 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BJ BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB (C) BEVACIZUMAB BEMABIX 16ML VIAL C 3811.28 3811.28 INJECTION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2022-04-01 2023-03-31 Delete from contract IV 0 ANTINEOPLASTICS 2023-03-07
41 4181BR BEVACIREL 25MG/ML INJ (RLS) BEVACIZUMAB (C) BEVACIZUMAB BEVACIREL 4ML VIAL C 430.58 430.5825 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 4181BS BEVIXA 25MG/ML INJ (INC) BEVACIZUMAB (C) BEVACIZUMAB BEVIXA 4ML VIAL C 925.75 925.7524 VIAL 0 VIAL INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS