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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 0671D UNIBLASTIN 10MG INJ (UBI/RXP) VINBLASTINE VINBLASTINE UNIBLASTIN 10MG VIAL BQ 54.37 54.37 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 0671F VINBLASTINE 10MG INJ (KWA) (BQ) VINBLASTINE VINBLASTINE 10MG VIAL BQ 26.94 26.9386 VIAL 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS