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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
41 09415 PANCURONIUM BROMIDE 2MG/ML INJ (CIR (B) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 10X2ML B 52.3 5.2301 AMP 0 BOX CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 NEUROMUSCULAR BLOCKING AGENTS
40 0941F PANCURONIUM BROMIDE 2MG/ML INJ (RTM/PHA) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 5X2ML BQ 40.23 8.05 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0941F PANCURONIUM BROMIDE 2MG/ML INJ (RTM (B) PANCURONIUM BROMIDE PANCURONIUM BROMIDE 5X2ML B 114.63 22.9263 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 NEUROMUSCULAR BLOCKING AGENTS