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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 0051F CAPECITABINE 150MG TAB (INP/AHI) CAPECITABINE CAPECITABINE 6X10 BQ 194.20 3.24 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 0051J CAPECITABINE 150MG TAB (WAT) CAPECITABINE CAPECITABINE 60'S BQ 175.3319 2.9222 TAB 230 BOTT WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 00521 XELODA 500MG TAB (ROC/AHI) CAPECITABINE CAPECITABINE XELODA 120'S C 326.20 2.72 TABLET 0 TAB ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
40 00527 KAPETRAL 500MG TAB (REM/SBI) CAPECITABINE CAPECITABINE KAPETRAL 120'S BQ 103.41 0.86 TABLET 0 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 00527 KAPETRAL 500MG TAB (REM) CAPECITABINE (BQ) CAPECITABINE KAPETRAL 120'S BQ 83.62 0.6968 TAB 60 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
41 0052AH CAPETAZ 500MG TAB (ZUV) CAPECITABINE (BQ) CAPECITABINE CAPETAZ 120'S BQ 41.1 0.3425 TAB 60 BOX ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2024-04-01 2024-05-20 ORAL 6 ANTINEOPLASTICS 2024-04-08
41 0052HF CAPETAZ 500MG TAB (ZUV) CAPECITABINE CAPECITABINE CAPETAZ 30'S BQ 31.57 1.0523 TAB 60 BOX ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2024-04-11 2026-03-31 ORAL 6 ANTINEOPLASTICS 2024-04-11