Displaying 1 - 20 of 78
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 0212BQ IMIPENEM/CILASTATIN |500MG INJ (LDP) CILASTATIN|IMIPENEM CILASTATIN|IMIPENEM IMIPENEM/CILASTATIN 1 DOSE BQ 27.56 27.56 VIAL VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 08120708 CARBAPENEMS 2024-04-03 2026-03-31 INJECTION CARBAPENEMS 2024-04-03
42 0212BQ CILASTATIN|IMIPENEM 500MG|500MG INJ (LDP) CILASTATIN|IMIPENEM CILASTATIN|IMIPENEM 500MG VIAL BQ 23.87 23.87 VIAL 0 VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 08120708 CARBAPENEMS 2026-04-01 IV 0 CARBAPENEMS
40 0225H LACLOXA 500MG INJ (LDP/AHI) CLOXACILLIN CLOXACILLIN LACLOXA 500MG VIAL B 15.41 15.41 INJECTION 0 VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2022-04-01 2022-09-30 IV 6 ANTI-INFECTIVE AGENTS 2022-03-29
41 0225M LACLOXA 500MG INJ (LDP) CLOXACILLIN (B) CLOXACILLIN LACLOXA 10X5ML B 62.79 6.2793 VIAL 56 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2024-04-01 2026-03-31 IV 6 PENICILLINS
40 0302AA LACLIDA 150MG/ML INJ (LDP/AHI) CLINDAMYCIN PH CLINDAMYCIN PHOSPHATE LACLIDA 10X4ML BQ 79.86 7.99 INJECTION 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 08122820 LINCOMYCINS 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
40 0314B FUSIDIC ACID DRESSING 1% (LDP/AHI) FUSIDIC ACID FUSIDIC ACID DRESSING 10'S A 19.14 19.14 10 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 840404 ANTIBIOTICS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 0314B FUSIDIC ACID DRESSING 1% DRESSING (LDP) FUSIDIC ACID FUSIDIC ACID DRESSING 10'S A 18.97 1.8974 EACH 10 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 840404 ANTIBIOTICS TOPICAL 2024-04-01 2026-03-31 TOPICAL 6 ANTIBIOTICS TOPICAL
42 0314B FUSIDIC ACID DRESSING 1% DRESSING (LDP) FUSIDIC ACID FUSIDIC ACID DRESSING 10'S A 18.97 1.90 EACH 10 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 840404 ANTIBIOTICS TOPICAL 2026-04-01 Add to Contract as Cat A TOPICAL 6 ANTIBIOTICS TOPICAL 2026-03-18
40 0472A DAPSONE 100MG TAB (LDP/AHI) DAPSONE DAPSONE 100'S A 32.62 0.33 TABLET 90 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081692 ANTIMYCOBACTERIALS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
41 0472A DAPSONE 100MG TAB (LDP) DAPSONE DAPSONE 100'S A 32.62 0.3262 TAB 90 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081692 ANTIMYCOBACTERIALS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTIMYCOBACTERIALS, MISCELLANEOUS
40 0692J LASTIGMINE 2.5MG/ML INJ (LDP/AHI) NEOSTIGMINE LASTIGMINE 5X1ML BQ 16.99 3.40 INJECTION 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2022-09-30 IV 0 AUTONOMIC DRUGS 2022-03-29
40 0694C LASTIGMINE PLUS 2.5MG/ML INJ (LDP/AHI) NEOSTIGMINE LASTIGMINE PLUS 5X5ML BQ 26.10 5.22 INJECTION 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2022-09-30 IV 0 AUTONOMIC DRUGS 2022-03-29
41 0694C LASTIGMINE PLUS 2.5MG/ML INJ (LDP) (BQ) NEOSTIGMINE LASTIGMINE PLUS 5X5ML BQ 29.58 5.9151 AMP 0 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2024-04-01 2026-03-31 IV 0 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS
40 0741K BENCOGEN 2MG TAB (LDP/AHI) BENZTROPINE BENZTROPINE BENCOGEN 1000'S A 77.64 0.08 TABLET 90 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 283608 ANTICHOLINERGIC AGENTS (PARKINSONS) 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 0741M BENZTROPINE 2MG TAB (LAB) BENZTROPINE BENZTROPINE 1000'S A 68.37 0.07 TAB 90 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 283608 ANTICHOLINERGIC AGENTS (PARKINSONS) 2026-04-01 ORAL 6 ANTICHOLINERGIC AGENTS (PARKINSONS)
41 0861H LADRELINE 1MG/ML INJ (LDP) NORADRENALINE (BQ) NORADRENALINE LADRELINE 5X4ML BQ 14.19 2.8379 AMP 0 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM 0 ALPHA & BETA ADRENERGIC AGONIST
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
40 1074S DIGOXIN 0.25MG/ML INJ (LDP/AHI) DIGOXIN DIGOXIN 10X2ML B 19.16 1.92 INJECTION 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 24040492 CARDIAC GLYCOSIDES 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
41 1161AA HYDRALLAZINE 25MG TAB (LDP) HYDRALLAZINE HYDRALLAZINE 250'S A 14.87 0.0595 TAB 120 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
40 1163J LAHYZINE 20MG/ML INJ (LDP/AHI) HYDRALLAZINE HYDRALLAZINE LAHYZINE 20MG VIAL B 5.71 5.71 INJECTION 0 VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 240820 DIRECT VASODILATOR 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS