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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 05743 ENDOXAN 50MG TAB (BAX/STO) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE ENDOXAN 50'S B 0.95 0.02 TABLET 0 TAB BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
41 05743 ENDOXAN 50MG TAB (BAX) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE ENDOXAN 50'S A 1.33 0.0266 TAB 240 BOX BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 05752 ENDOXAN 1G INJ (ASM/COL) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE ENDOXAN 1G VIAL BQ 38.06 38.06 INJECTION 0 VIAL ASM ASTA MEDICA AG COL COLLINS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 05756 ENDOXAN 1G INJ (BAX/STO) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE ENDOXAN 1G VIAL BQ 15.96 15.96 INJECTION 0 VIAL BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 05756 ENDOXAN 1G INJ (BAX) CYCLOPHOSPHAMIDE (BQ) CYCLOPHOSPHAMIDE ENDOXAN 1G VIAL BQ 17.34 17.3429 VIAL 30 VIAL BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS
41 0575F CYCLOPHOSPHAMIDE 1G INJ (KWA) (BQ) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE 1G VIAL BQ 10.41 10.4112 VIAL 30 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS