Displaying 1 - 20 of 131
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 0051F CAPECITABINE 150MG TAB (INP/AHI) CAPECITABINE CAPECITABINE 6X10 BQ 194.20 3.24 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
42 0051M CAPECITABINE 150MG TAB (INP) CAPECITABINE CAPECITABINE 10'S BQ 15.79 1.58 TAB 230 PACK INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 ORAL 0 ANTINEOPLASTICS
41 0111FA ADORA 500MG CAP (INC) CEFADROXIL CEFADROXIL ADORA 20'S A 8.07 0.4037 CAP 28 BOX INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 08120604 FIRST GEN CEPHALOSPORINS 2024-04-01 2026-03-31 ORAL 0 FIRST GEN CEPHALOSPORINS
42 0111FA ADORA 500MG CAP (INC) CEFADROXIL CEFADROXIL ADORA 20'S A 8.26 0.41 CAP 28 BLIS INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 08120604 FIRST GEN CEPHALOSPORINS 2026-04-01 ORAL 0 FIRST GEN CEPHALOSPORINS
41 0113BA CEFAZOL 1G INJ (INC) (BQ) CEFAZOLIN CEFAZOL 15ML VIAL BQ 14.19 14.1897 VIAL 0 VIAL INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 08120604 FIRST GEN CEPHALOSPORINS 2024-04-01 2026-03-31 IV/IM 0 FIRST GEN CEPHALOSPORINS
42 0131B AZITHRO EZE 40MG/ML SUSP (INF) AZITHROMYCIN AZITHROMYCIN AZITHRO EZE 15ML A 4.59 0.31 ML 30 BOTT INF INFOCUS REMEDIES PVT RXP RX PRO INC B 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
42 0451BW CO TRIMOX EZE 400MG|80MG TAB (INF) SULFAMETHOXAZOLE|TRIMETHO SULFAMETHOXAZOLE|TRIMETHOPRIM CO TRIMOX EZE 10X10 A 7.20 0.07 TAB 56 BLIS INF INFOCUS REMEDIES PVT RXP RX PRO INC 081220 SULPHONAMIDES 2026-04-01 ORAL 0 SULPHONAMIDES
42 0481BA METRON EZE 400MG TAB (INF) METRONIDAZOLE METRONIDAZOLE METRON EZE 10X10 A 12.78 0.13 TAB 90 BLIS INF INFOCUS REMEDIES PVT RXP RX PRO INC 083092 ANTIPROTOZOALS, MISCELLANEOUS 2026-04-01 ORAL 0 ANTIPROTOZOALS, MISCELLANEOUS
42 0481BB FLAMYD 250MG TAB (INC) METRONIDAZOLE METRONIDAZOLE FLAMYD 100'S A 7.01 0.07 TAB 90 BLIS INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 083092 ANTIPROTOZOALS, MISCELLANEOUS 2026-04-01 ORAL 0 ANTIPROTOZOALS, MISCELLANEOUS
40 0582B CYTARABINE 1G INJ (INP/AHI) CYTARABINE CYTARABINE 1G VIAL BQ 38.46 38.46 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0631AD METHOTREXATE 2.5MG TAB (INP/AHI) METHOTREXATE METHOTREXATE 100'S A 12.72 0.13 TABLET 32 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
40 0633V METHACOR 25MG/ML INJ (INP/AHI) METHOTREXATE METHOTREXATE METHACOR 2ML VIAL B 8.70 8.70 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0634M METHOTREXATE 25MG/ML INJ (INP/AHI) METHOTREXATE METHOTREXATE 20ML VIAL BQ 46.43 46.43 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 06351 METHOTREXATE 25MG/ML INJ (INP/AHI) METHOTREXATE METHOTREXATE 40ML BQ 82.12 82.12 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 06417 ACCORD MITOMYCIN 5MG INJ (INP/AAL) MITOMYCIN MITOMYCIN ACCORD MITOMYCIN 5MG VIAL BQ 203.06 203.06 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 0791Y ADRINOR 1MG/ML IV/IM INJ (INC) ADRENALINE (B) ADRENALINE ADRINOR 5X1ML B 9.05 1.8104 AMP 60 BOX INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM/SC 0 ALPHA & BETA ADRENERGIC AGONIST
40 11045 ACCORD PROPRANOLOL 80MG TAB (INP/AAL) PROPRANOLOL ACCORD PROPRANOLOL 56'S A 13.40 0.24 TABLET 150 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1131FW LIPITAS 10MG TAB (INP/AHI) ATORVASTATIN ATORVASTATIN LIPITAS 30'S A 3.56 0.1187 TABLET IMMED INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 240608 HMG-CoA REDUCTASE INHIBITORS 2023-03-20 2024-03-31 Add to Contract as Cat A Oral 6 HMG-CoA REDUCTASE INHIBITORS 2023-01-04
41 1131GT ATORVASTATIN 10MG TAB (INP) ATORVASTATIN ATORVASTATIN 1000'S A 35.96 0.036 TAB 30 BOTT INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
40 1132HE LIPITAS 20MG TAB (INP/AHI) ATORVASTATIN ATORVASTATIN LIPITAS 30'S A 4.32 0.144 TABLET IMMED 30 INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 240608 HMG-CoA REDUCTASE INHIBITORS 2023-03-20 2024-03-31 Add to Contract as Cat A Oral 6 HMG-CoA REDUCTASE INHIBITORS 2023-01-04