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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 0611B MELPHALAN 2MG TAB (TPP/AHI) MELPHALAN MELPHALAN 50'S A 75.05 1.50 TABLET 63 TAB TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 0611C MELPHALAN 2MG TAB (KWA) MELPHALAN MELPHALAN 50'S A 83.18 1.6636 TAB 63 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS