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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 7111G CISPA 1MG/ML INJ (INP/AHI) CISPLATIN CISPLATIN CISPA 50ML VIAL BQ 19.06 19.06 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 7111R CISPLATIN 1MG/ML INJ (DIL/AHI) CISPLATIN CISPLATIN 50ML BQ 18.02 18.02 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 7111S CISPLATIN 1MG/ML INJ (FSB) (BQ) CISPLATIN CISPLATIN 50ML VIAL BQ 15.01 15.0051 VIAL 50 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 7111W CISPLATIN 1MG/ML INJ (KWA) (BQ) CISPLATIN CISPLATIN 50ML BQ 16.34 16.3371 VIAL 50 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 71123 CISPLATIN 1MG/ML INJ (KWA) (BQ) CISPLATIN CISPLATIN 100ML BQ 27.59 27.591 VIAL 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 71124 CISPLATIN 1MG/ML INJ (VEN) (BQ) CISPLATIN CISPLATIN 100ML BQ 29.19 29.1948 VIAL 0 VIAL VEN VENUS REMEDIES LIMITED AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS