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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 0951L SUXAMETHONIUM 50MG/ML INJ (SLS/AHI) SUXAMETHONIUM SUXAMETHONIUM 10X10ML B 43.11 4.31 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0951N LASULINE PLUS 50MG/ML INJ (LDP) SUXAMETHONIUM SUXAMETHONIUM LASULINE 10X10ML B 133.74 13.3742 VIAL 100 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV/IM 0 NEUROMUSCULAR BLOCKING AGENTS