Displaying 1 - 20 of 20
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 0603B FLUOROURACIL 50MG/ML INJ (DIL) (BQ) FLUOROURACIL FLUOROURACIL 10X10ML BQ 126.97 12.6973 VIAL 0 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 1103E PROPRANOLOL 1MG/ML INJ (DIL/AHI) PROPRANOLOL PROPRANOLOL 10X1ML BQ 135.37 13.54 INJECTION 0 AMP DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
41 1103E PROPRANOLOL 1MG/ML INJ (DIL) PROPRANOLOL PROPRANOLOL 10X1ML BQ 135.37 13.5372 AMP 30 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS
41 1163K HYDRALLAZINE 20MG/ML INJ (DIL) (B) HYDRALLAZINE HYDRALLAZINE 25X1ML B 938.75 37.5498 VIAL 0 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 IV 0 DIRECT VASODILATOR
40 1611N DOCETAXEL 20MG INJ (DIL/AHI) DOCETAXEL DOCETAXEL 20MG VIAL C 36.02 36.02 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 2592AD FAMOTIDINE 10MG/ML INJ (DIL/AHI) FAMOTIDINE FAMOTIDINE 25X2ML B 120.97 4.84 INJECTION 0 AMP DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 562812 HISTAMINE RECEPTOR ANTAGONIST 2022-04-01 2024-03-31 IV 0 GASTROINTESTINAL DRUGS
41 39648 SODIUM VALPROATE 100MG/ML INJ (DIL) (B) SODIUM VALPROATE SODIUM VALPROATE 10X5ML B 142.66 14.2658 VIAL 0 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 IV 0 ANTICONVULSANTS MISCELLANEOUS
40 4021C AZITHROMYCIN 500MG INJ (DIL/AHI) AZITHROMYCIN AZITHROMYCIN 10X500MG BQ 403.83 40.38 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 08121292 OTHER MACROLIDES 2022-04-01 2022-09-30 IV 0 ANTI-INFECTIVE AGENTS 2022-03-29
40 4222G ACETYLCYSTEINE 20% SOLN (DIL/AHI) ACETYLCYSTEINE ACETYLCYSTEINE 3X30ML BQ 273.82 91.27 SOLUTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9212 ANTIDOTES 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 5422G TOBRAMYCIN 40MG/ML INJ (DIL) (BQ) TOBRAMYCIN TOBRAMYCIN 25X2ML BQ 482.39 19.2958 VIAL 0 BOX DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 081202 AMINOGLYCOSIDES 2024-04-01 2026-03-31 IV 0 AMINOGLYCOSIDES
40 55511 THALIDOMIDE 50MG CAP (DIL/AHI) THALIDOMIDE THALIDOMIDE 30'S C 62.25 2.08 CAPSULE 0 CAP DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9220 BIOLOGIC RESPONSE MODIFIER 2022-04-01 2024-03-31 Oral 0 UNCLASSIFIED THERAPEUTIC AGENTS
42 55511 THALIDOMIDE 50MG CAP (DIL) THALIDOMIDE THALIDOMIDE 30'S C 48.11 1.60 CAP 0 BLIS DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9220 BIOLOGIC RESPONSE MODIFIER 2026-04-01 ORAL 0 BIOLOGIC RESPONSE MODIFIER
40 55521 THALIDOMIDE 100MG CAP (DIL/AHI) THALIDOMIDE THALIDOMIDE 30'S C 110.50 3.68 CAPSULE 0 CAP DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9220 BIOLOGIC RESPONSE MODIFIER 2022-04-01 2024-03-31 Oral 0 UNCLASSIFIED THERAPEUTIC AGENTS
42 55521 THALIX 100MG CAP (DIL) THALIDOMIDE THALIDOMIDE THALIX 30'S C 60.18 2.01 CAP 0 BLIS DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9220 BIOLOGIC RESPONSE MODIFIER 2026-04-01 ORAL 0 BIOLOGIC RESPONSE MODIFIER
40 65216 PENTAMIDINE 300MG INJ (DIL/AHI) PENTAMIDINE PENTAMIDINE 10X15ML C 6,415.24 641.52 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 083092 ANTIPROTOZOALS, MISCELLANEOUS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
41 7093F CARBOPLATIN 450MG INJ (DIL) (BQ) CARBOPLATIN CARBOPLATIN 450MG VIAL BQ 91.58 91.5803 VIAL 10 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 7111R CISPLATIN 1MG/ML INJ (DIL/AHI) CISPLATIN CISPLATIN 50ML BQ 18.02 18.02 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 71214 FLUMAZENIL 0.1MG/ML INJ (DIL/AHI) FLUMAZENIL FLUMAZENIL 10X5ML B 180.66 18.07 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
40 A591AA DOXORUBICIN 50MG SOLN FOR INJ (DIL/AHI) DOXORUBICIN DOXORUBICIN 50MG VIAL BQ 25.91 25.91 SOLUTION FOR 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 A751D OCTREOTIDE 0.1MG/ML INJ (DIL/AHI) OCTREOTIDE OCTREOTIDE 10X1ML BQ 24.55 2.46 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9292 OTHER THERAPEUTIC AGENTS 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS