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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
42 0521A ACTINOMYCIN D 500MCG INJ (KWA) DACTINOMYCIN DACTINOMYCIN ACTINOMYCIN D 500MCG VIA BQ 16.72 16.72 VIAL 0 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2026-04-01 Add to Contract IV 0 ANTINEOPLASTICS 2026-03-02