Displaying 1 - 20 of 52
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 0991J FERROUS SULPHATE | FOLIC ACID 200MG | 0.4MG TAB (LRL/COL) FERROUS SULPHATE|FOLIC ACID FERROUS SULPHATE|FOLIC ACID 1000'S A 40.37 0.04 TABLET 90 TAB LRL LOMAPHARM RUDOLF LOHMANN GMBH KG COL COLLINS LTD 200404 IRON PREPARATIONS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 0991J FERROUS SULPHATE|FOLIC ACID 200MG|0.4MG TAB (LRL) FERROUS SULPHATE|FOLIC ACID FERROUS SULPHATE|FOLIC ACID 1000'S A 28.71 0.0287 TAB 90 BOTT LRL LOMAPHARM RUDOLF LOHMANN GMBH KG COL COLLINS LTD 200404 IRON PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 IRON PREPARATIONS
40 1241E RALOXIFENE 60MG TAB (DRL/AHI) RALOXIFENE RALOXIFENE 30'S C 39.88 1.33 TABLET 0 TAB DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 681612 ESTROGEN AGONIST-ANTAGONIST 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 1542A DIAMIN 25MG TAB (RLS/AHI) IMIPRAMINE IMIPRAMINE DIAMIN 200'S A 18.87 0.09 TABLET 240 TAB RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 28160428 TRICYCLICS & OTHER NOREPINEPHRINE REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 1611U DOCETERE 20MG INJ (DRL/AAL) DOCETAXEL DOCETAXEL DOCETERE 1 DS SYRNG C 39.96 39.96 INJECTION 0 PFS DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 2831GP GLIMEPIRIDE 2MG TAB (DRL/AHI) GLIMEPIRIDE GLIMEPIRIDE 100'S C 12.75 0.13 TABLET 0 TAB DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 2832BS GLIMEPIRIDE 4MG TAB (DRL/AHI) GLIMEPIRIDE GLIMEPIRIDE 100'S C 14.62 0.15 TABLET 0 TAB DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 3081Y IMMUNOREL 5% INJ (RLS/AHI) IMMUNOGLOBULIN IMMUNOGLOBULIN HUMAN IMMUNOREL 100ML BQ 657.29 657.29 INJECTION 0 BOTT RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 8004 SERUMS 2022-04-01 2024-03-31 IV 0 SERUMS, TOXOIDS AND VACCINES
41 3081Y IMMUNOREL 5% INJ (RLS) IMMUNOGLOBUL (BQ) IMMUNOGLOBULIN HUMAN IMMUNOREL 100ML BQ 807.34 807.3422 BOTT 0 BOTT RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 8004 SERUMS 2024-04-01 2026-03-31 IV 0 SERUMS
42 3081Y IMMUNOREL 5% INJ (RLS) IMMUNOGLOBUL IMMUNOGLOBULIN HUMAN IMMUNOREL 100ML BQ 807.34 807.34 BOTT 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 8004 SERUMS 2026-04-01 IV 0 SERUMS
41 3082A IMMUNOREL 10% INJ (RLS) IMMUNOGLOBU (BQ) IMMUNOGLOBULIN IMMUNOREL 100ML BQ 1353.73 1353.7254 VIAL 50 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 8004 SERUMS 2024-04-01 2026-03-31 IV 0 SERUMS
40 31717 ADALIREL 40MG INJ (RLS/AHI) ADALIMUMAB ADALIMUMAB ADALIREL 0.8ML SYRN C 875.30 875.30 INJECTION 0 PFS RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BA REDITUX 10MG/ML INJ (DRL/AAL) RITUXIMAB RITUXIMAB REDITUX 50ML C 383.56 383.56 INJECTION 0 VIAL DRL DR. REDDY'S LABORATORIES LTD AAL A. A. LAQUIS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 4181BK INFLIXIRIL 100MG INJ (RLS/AHI) INFLIXIMAB INFLIXIMAB INFLIXIRIL 100ML C 1,058.52 1,058.52 INJECTION 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 4181BR BEVACIREL 25MG/ML INJ (RLS) BEVACIZUMAB (C) BEVACIZUMAB BEVACIREL 4ML VIAL C 430.58 430.5825 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 4181N RITUXIMAB 10MG/ML INJ (RLS) (BQ) RITUXIMAB RITUXIMAB 10ML BQ 190.01 190.0108 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
40 44619 RIVASTIGMINE 1.5MG CAP (DRL/AHI) RIVASTIGMINE RIVASTIGMINE 60'S C 143.36 2.39 CAPSULE 0 CAP DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 4462A RIVASTIGMINE 3MG CAP (DRL/AHI) RIVASTIGMINE RIVASTIGMINE 60'S C 137.38 2.29 CAPSULE 0 CAP DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 4463J RIVASTIGMINE 4.5MG TAB (DRL/AHI) RIVASTIGMINE RIVASTIGMINE 60'S C 96.69 1.61 TABLET 0 CAP DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 4464K RIVASTIGMINE 6MG CAP (DRL/AHI) RIVASTIGMINE RIVASTIGMINE 60'S C 107.32 1.79 CAPSULE 0 CAP DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS