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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
41 6432D FOLINIC ACID 50MG INJ (ZUV) CALCIUM FOLI (BQ) CALCIUM FOLINATE FOLINIC ACID 50MG VIAL BQ 5.57 5.5726 VIAL 0 VIAL ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 9212 ANTIDOTES 2024-04-01 2026-03-31 INJ 0 ANTIDOTES
42 6432D FOLINIC ACID 50MG INJ (ZUV) CALCIUM FOLI CALCIUM FOLINATE FOLINIC ACID 50MG VIAL BQ 4.65 4.65 VIAL 0 VIAL ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 9212 ANTIDOTES 2026-04-01 INJ 0 ANTIDOTES