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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
41 6591P DOBUTAMINE 12.5MG/ML INJ (SLS) (BQ) DOBUTAMINE DOBUTAMINE 20ML BQ 9.73 9.7316 VIAL 30 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV 6 BETA ADRENERGIC AGONIST
40 6591R DOBUTAMINE 12.5MG/ML INJ (RTM/PHA) DOBUTAMINE DOBUTAMINE 20ML BQ 6.03 6.03 INJECTION 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121208 BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 6591R DOBUTAMINE 12.5MG/ML INJ (RTM) (BQ) DOBUTAMINE DOBUTAMINE 20ML BQ 11.47 11.4713 VIAL 30 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121208 BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV 6 BETA ADRENERGIC AGONIST
40 6591V LABUTAMINE 12.5MG/ML INJ (LDP/AHI) DOBUTAMINE DOBUTAMINE LABUTAMINE 20ML BQ 8.07 8.07 INJECTION 0 VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS