Displaying 1 - 9 of 9
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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 41811 MABTHERA 10MG/ML INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA 100MG VIAL C 1,391.78 1,391.78 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 41811 MABTHERA 10MG/ML INJ (ROC) RITUXIMAB (BQ) RITUXIMAB MABTHERA 100MG VIAL BQ 1391.78 1391.7819 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 4181BA REDITUX 10MG/ML INJ (DRL/AAL) RITUXIMAB RITUXIMAB REDITUX 50ML C 383.56 383.56 INJECTION 0 VIAL DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BB MABTHERA 10MG/ML INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA 50ML C 3,479.45 3,479.45 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181BB MABTHERA 10MG/ML INJ (ROC) RITUXIMA (BQ) RITUXIMAB MABTHERA 50ML BQ 3479.45 3479.4547 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 4181BC MABTHERA SC 1400MG INJ (ROC/AHI) RITUXIMAB RITUXIMAB MABTHERA SC 11.7ML C 4,392.81 4,392.81 INJECTION 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181BC MABTHERA SC 1400MG INJ (ROC) RITUXIMAB (BQ) RITUXIMAB MABTHERA SC 11.7ML BQ 4392.81 4392.8116 VIAL 0 VIAL ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 4181N RITUXIMAB 10MG/ML INJ (RLS) (BQ) RITUXIMAB RITUXIMAB 10ML BQ 190.01 190.0108 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 4181Y RIXATHON 10MG/ML INJ (BCH) RITUXIMAB (BQ) RITUXIMAB RIXATHON 2X10ML BQ 768.91 384.4525 VIAL 0 BOX BCH SANDOZ COL COLLINS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS