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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 7091M CARBOPLATIN 150MG INJ (INP/AHI) CARBOPLATIN CARBOPLATIN 150MG VIAL BQ 36.91 36.91 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 7091N CARBOPLATIN 150MG INJ (FSB) (BQ) CARBOPLATIN CARBOPLATIN 150MG VIAL BQ 36.97 36.9692 VIAL 10 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS
41 7093F CARBOPLATIN 450MG INJ (DIL) (BQ) CARBOPLATIN CARBOPLATIN 450MG VIAL BQ 91.58 91.5803 VIAL 10 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 7093L CARBOPLATIN 450MG INJ (FSB/ATB) CARBOPLATIN CARBOPLATIN 450MG VIAL BQ 76.11 76.11 INJECTION 0 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 7093L CARBOPLATIN 450MG INJ (FSB) (BQ) CARBOPLATIN CARBOPLATIN 450MG VIAL BQ 76.17 76.1674 VIAL 10 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 7093N CARBOPLATIN 450MG INJ (INP/AHI) CARBOPLATIN CARBOPLATIN 450MG VIAL BQ 84.62 84.62 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS