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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 05616 CHLORAMBUCIL 2MG TAB (KWA/ATB) CHLORAMBUCIL CHLORAMBUCIL 3X10 A 176.69 5.89 TABLET 240 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 1000 ANTINEOPLASTICS 2022-05-27 2024-03-31 Package Size Change Oral 6 ANTINEOPLASTICS 2022-05-27