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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 71214 FLUMAZENIL 0.1MG/ML INJ (DIL/AHI) FLUMAZENIL FLUMAZENIL 10X5ML B 180.66 18.07 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
41 7121C FLUMAZENIL 0.1MG/ML INJ (LDP) FLUMAZENIL FLUMAZENIL 10X5ML B 156.98 15.6983 VIAL 0 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 IV 0 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
42 7121F FLUMAZENIL 0.1MG/ML INJ (FSB) FLUMAZENIL FLUMAZENIL 5ML PFS BQ 125.40 125.40 PFS 0 FSB FLAGSHIP BIOTECH STO BRYDEN STOKES LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2026-04-01 Add to Contract IV 0 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU 2026-03-05
42 7121G FLUMAZENIL 0.1MG/ML INJ (ROL) FLUMAZENIL FLUMAZENIL 10X5ML BQ 2,651.18 265.12 VIAL 0 VIAL ROL ROXANE LABORATORIES INC. AHI ARMSTRONG HEALTHCARE INC 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2026-04-02 Add to Contract IV 0 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU 2026-04-02