Displaying 1 - 14 of 14
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 0081AG AMPHOTIN 50MG INJ (UBI/RXP) AMPHOTERICIN B AMPHOTERICIN B AMPHOTIN 50MG VIAL BQ 19.71 19.71 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 081428 POLYENES 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
40 0301Q CLINDATECH 150MG/ML INJ (UBI/RXP) CLINDAMYCIN CLINDAMYCIN PHOSPHATE CLINDATECH 2ML AMP BQ 6.12 6.12 INJECTION 0 AMP UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 08122820 LINCOMYCINS 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
40 05217 DACTINOTEC 500MCG INJ (UBI/RXP) ACTINOMYCIN D ACTINOMYCIN D DACTINOTEC 500MCG BQ 31.26 31.26 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0582D ONCOTAR 1G INJ (UBI/RXP) CYTARABINE CYTARABINE ONCOTAR 1G VIAL BQ 31.26 31.26 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0633X UNITREXATE 25MG/ML INJ (UBI/RXP) METHOTREXATE METHOTREXATE UNITREXATE 2ML VIAL B 7.07 7.07 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0671D UNIBLASTIN 10MG INJ (UBI/RXP) VINBLASTINE VINBLASTINE UNIBLASTIN 10MG VIAL BQ 54.37 54.37 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0681Q UNICRISTINE 1MG INJ (UBI/RXP) VINCRISTINE VINCRISTINE UNICRISTINE 1MG VIAL BQ 7.07 7.07 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 2353D PHRINTEC 10MG/ML IV/IM INJ (UBI/RXP) PHENYLEP PHENYLEPHRINE PHRINTEC 1ML VIAL B 10.60 10.60 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 121204 ALPHA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV/IM 0 AUTONOMIC DRUGS
40 2931Y VASMED 20U/ML INJ (UBI/RXP) VASOPRESSIN VASOPRESSIN VASMED 1ML AMP BQ 10.47 10.47 INJECTION 0 AMP UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 6828 PITUITARY 2022-04-01 2024-03-31 IV 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 4222H MUCOSYS 20% INJ (UBI/RXP) ACETYLCYSTEINE ACETYLCYSTEINE MUCOSYS 10ML BQ 8.83 8.83 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 9212 ANTIDOTES 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
40 4463M DONEPEZIL 5MG TAB (JUB/AHI) DONEPEZIL DONEPEZIL 90'S A 25.82 0.29 TABLET 30 TAB JUB JUBILANT LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 deleted from Contract Oral 6 AUTONOMIC DRUGS
40 4463M DONEPEZIL 5MG TAB (JUB/AHI) DONEPEZIL DONEPEZIL 90'S A 25.82 0.29 TABLET 30 TAB JUB JUBILANT LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 deleted from Contract Oral 6 AUTONOMIC DRUGS
40 5422J TOCIN 40MG/ML INJ (UBI/RXP) TOBRAMYCIN TOBRAMYCIN TOCIN 2ML VIAL BQ 8.97 8.97 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 081202 AMINOGLYCOSIDES 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
40 A1917 BIOGLANDIN 500MCG/ML INJ (UBI/RXP) ALPROSTADI ALPROSTADIL BIOGLANDIN 1ML AMP BQ 237.85 237.85 INJECTION 0 AMP UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 241292 VASODILATING AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS