Displaying 1 - 12 of 12
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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 A0411 CELLCEPT 500MG CAP (ROC/AHI) MYCOPHENOLATE MYCOPHENOLATE CELLCEPT 50'S BQ 190.28 3.81 CAPSULE 0 CAP ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2022-04-01 2024-03-31 Oral 6 UNCLASSIFIED THERAPEUTIC AGENTS
41 A0411 CELLCEPT 500MG CAP (ROC) MYCOPHENOL (C) MYCOPHENOLATE CELLCEPT 50'S C 190.28 3.8057 CAP 180 BOX ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
42 A0411 CELLCEPT 500MG CAP (ROC) MYCOPHENOL MYCOPHENOLATE CELLCEPT 50'S BQ 190.28 3.81 CAP 180 BLIS ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2026-04-01 ORAL 0 IMMUNOSUPPRESSIVE AGENTS
40 A0412 MYFORTIC 360MG CAP (NVS/COL) MYCOPHENOLATE MYCOPHENOLATE MYFORTIC 120'S C 641.52 5.35 CAPSULE 0 CAP NVS NOVARTIS CARIBE SA COL COLLINS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2022-04-01 2024-03-31 Oral 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 A0412 MYFORTIC 360MG CAP (NVS) MYCOPHENOLATE (C) MYCOPHENOLATE MYFORTIC 120'S C 641.52 5.346 CAP 240 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
41 A041L APO-MYCOPHENOLATE 500MG TAB (APO) (BQ) MYCOPHENOLATE APO-MYCOPHENOLATE 50'S BQ 51.02 1.0205 TAB 180 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 0 IMMUNOSUPPRESSIVE AGENTS
41 A041N MYCOPHENOLATE 360MG TAB (INP) (C) MYCOPHENOLATE MYCOPHENOLATE 50'S C 224.26 4.4852 TAB 0 BOX INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 0 IMMUNOSUPPRESSIVE AGENTS
41 A041Q MOFILET 500MG TAB (EMC) MYCOPHENOLATE MYCOPHENOLATE MOFILET 60'S BQ 61.98 1.033 TAB 180 BOX EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 0 IMMUNOSUPPRESSIVE AGENTS 2024-03-07
40 A0421 CELLCEPT 250MG CAP (ROC/AHI) MYCOPHENOLATE MYCOPHENOLATE CELLCEPT 100'S BQ 190.28 1.90 CAPSULE 0 CAP ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2022-04-01 2024-03-31 Oral 6 UNCLASSIFIED THERAPEUTIC AGENTS
41 A0421 CELLCEPT 250MG CAP (ROC) MYCOPHENOL (C) MYCOPHENOLATE CELLCEPT 100'S C 190.28 1.9028 CAP 360 BOX ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
42 A0421 CELLCEPT 250MG CAP (ROC) MYCOPHENOL MYCOPHENOLATE CELLCEPT 100'S BQ 190.28 1.90 CAP 360 BLIS ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 9244 IMMUNOSUPPRESSIVE AGENTS 2026-04-01 ORAL 0 IMMUNOSUPPRESSIVE AGENTS
41 A042G APO-MYCOPHENOLATE 250MG CAP (APO) (BQ) MYCOPHENOLATE APO-MYCOPHENOLATE 100'S BQ 51.02 0.5102 CAP 360 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 IMMUNOSUPPRESSIVE AGENTS