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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 41817 REMICADE 100MG INJ (JAC/STO) INFLIXIMAB INFLIXIMAB REMICADE 20ML VIAL C 1,460.17 1,460.17 INJECTION 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 41817 REMICADE 100MG INJ (JAC) INFLIXIMAB (C) INFLIXIMAB REMICADE 20ML VIAL C 1460.17 1460.1749 VIAL 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2024-04-01 2026-03-31 IV 0 DISEASE MODIFYING ANTIRHEUMATIC AGENTS
42 41817 REMICADE 100MG INJ (JAC) INFLIXIMAB INFLIXIMAB REMICADE 20ML VIAL BQ 1,460.18 1,460.17 VIAL 0 VIAL JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 9236 DISEASE MODIFYING ANTIRHEUMATIC AGENTS 2026-04-01 IV 0 DISEASE MODIFYING ANTIRHEUMATIC AGENTS
40 4181BK INFLIXIRIL 100MG INJ (RLS/AHI) INFLIXIMAB INFLIXIMAB INFLIXIRIL 100ML C 1,058.52 1,058.52 INJECTION 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
42 4181CN REMSIMA 100MG INJ (CET) INFLIXIMAB INFLIXIMAB REMSIMA 100MG VIAL BQ 842.68 842.68 VIAL 0 VIAL CET CELLTRION SBI MASSY DISTRIBUTION (BDOS) LTD 1000 ANTINEOPLASTICS 2026-04-01 IV 0 ANTINEOPLASTICS