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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 19536 IBANDRONIC ACID 1MG/ML INJ (INP/AAL) IBANDRONIC ACID IBANDRONIC ACID 6ML VIAL C 9.51 9.51 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 9224 BONE RESORPTION INHIBITORS 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS