Displaying 1 - 9 of 9
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 0751Q HYOSCINE BUTYLBROMIDE 10MG TAB (MPI) HYOSCINE BUTYLBROMIDE HYOSCINE 100'S A 11.44 0.1144 TAB 120 BOTT MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 120808 ANTIMUSCARINICS/ANTISPASMODICS 2024-04-01 2026-03-31 ORAL 0 ANTIMUSCARINICS/ANTISPASMODICS
41 2683AS MECORT 1% CR (MPI) HYDROCORTISONE HYDROCORTISONE MECORT 15G A 2.91 2.9086 TUBE 2 TUBE MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 8406 ANTI-INFLAMMATORY AGENTS, TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTI-INFLAMMATORY AGENTS, TOPICAL
41 4141SG IBUPROFEN 400MG TAB (MPI) IBUPROFEN IBUPROFEN 10X10 A 8.7 0.087 TAB 120 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 5062AP REHYDRATION SALTS ORANGE PWDR (MPI) REHYDRATION SALTS REHYDRATION SALTS ORANGE 100'S A 32.57 0.3257 BOX 10 SACH MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2024-04-01 2026-03-31 ORAL 0 REPLACEMENT THERAPY
41 5851AE FLOMACOR 900MG|100MG TAB (MPI) DIOSMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN FLOMACOR 3X10 C 24.41 0.8137 TAB 0 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
41 5861KY TERBICIP 250MG TAB (MPI) TERBINAFINE TERBINAFINE TERBICIP 10'S A 4.59 0.4594 TAB 28 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 081408 AZOLES 2024-04-01 2026-03-31 ORAL 6 AZOLES
41 5861LB TERBINAFINE 250MG TAB (MPI) TERBINAFINE TERBINAFINE 50'S A 22.97 0.4594 TAB 28 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 081408 AZOLES 2024-10-29 2026-03-31 ORAL 6 AZOLES 2024-08-20
41 B041PD ESOMAC 20MG TAB (MPI) ESOMEPRAZOLE (C) ESOMEPRAZOLE ESOMAC 3X10 C 3.62 0.1205 TAB 0 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS
41 B041PE ESOMAC 40MG TAB (MPI) ESOMEPRAZOLE (C) ESOMEPRAZOLE ESOMAC 3X10 C 4.19 0.1395 TAB 0 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS