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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 06032 FLUOROURACIL 50MG/ML INJ (EBA/COL) FLUOROURACIL FLUOROURACIL 10ML BQ 26.48 26.48 INJECTION 0 VIAL EBA EBEW ARZNEIMITTLE GES.MBH COL COLLINS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 0603B FLUOROURACIL 50MG/ML INJ (DIL) (BQ) FLUOROURACIL FLUOROURACIL 10X10ML BQ 126.97 12.6973 VIAL 0 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 0603D FLUOROURACIL 50MG/ML INJ (SLS (BQ) FLUOROURACIL FLUOROURACIL 10ML BQ 18.67 18.6749 VIAL 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS