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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 0813C EPHEDRINE HCL 50MG/ML INJ (VEV/AHI) EPHEDRINE HYDROCHLORIDE EPHEDRINE HCL 10X1ML B 268.43 26.84 INJECTION 0 VIAL VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2022-09-30 IV 0 AUTONOMIC DRUGS 2022-03-29
42 1332L VERFEN 50MCG/ML INJ (VEV) FENTANYL FENTANYL CITRATE VERFEN 5X10ML BQ 23.65 4.73 AMPG 0 BOX VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2026-04-01 IV 0 OPIATE AGONISTS
40 1383D VERMOR SR 30MG TAB (VEV/AHI) MORPHINE SULPHATE SR MORPHINE SULPHATE SR VERMOR SR 10X10 A 64.70 0.65 TABLET 30 TAB VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 Oral 2 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-29
41 1383D VERMOR 30MG SR TAB (VEV) MORPHINE SULPHATE MORPHINE SULPHATE VERMOR 10X10 A 392.93 3.9293 TABSR 30 BOX VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 ORAL 2 OPIATE AGONISTS
42 1383D VERMOR 30MG SR TAB (VEV) MORPHINE SR MORPHINE SR VERMOR 10X10 B 404.16 4.04 TAB 0 BLIS VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2026-04-01 ORAL 0 OPIATE AGONISTS
40 13855 VERMOR IR 10MG TAB (VEV/AHI) MORPHINE SULPHAT MORPHINE SULPHATE VERMOR IR 10X10 A 49.56 0.50 TABLET 112 TAB VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 Oral 2 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-29
42 13855 VERMOR IR 10MG TAB (VEV) MORPHINE SULPHA MORPHINE SULPHATE VERMOR IR 10X10 B 178.02 1.78 TAB 112 BLIS VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 280808 OPIATE AGONISTS 2026-04-01 ORAL 2 OPIATE AGONISTS
42 15055 PHENOBARBITONE 200MG/ML INJ (VEV) PHENOBARBITONE PHENOBARBITONE 10X1ML BQ 32.29 3.23 AMPG 0 BOX VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 281204 BARBITURATES (ANTICONVULSANTS) 2026-04-01 IV 0 BARBITURATES (ANTICONVULSANTS)
41 1605B VERZEPAM 5MG/ML IV/IM INJ (VEV) DIAZEPAM (B) DIAZEPAM VERZEPAM 10X2ML B 29.36 2.9358 AMP 60 BOX VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 IV/IM 0 BENZODIAZEPINES (SEDATIVES)
41 1612X DOCETAXEL 80MG INJ (VEN) DOCETAXEL DOCETAXEL 4ML VIAL BQ 38.4643 38.4643 VIAL 0 VIAL VEN VENUS REMEDIES LIMITED AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
41 3681Q N-XONE 0.4MG/ML INJ (VEV) NALOXONE (B) NALOXONE N-XONE 10X1ML B 47.3 4.7299 AMP 0 BOX VEV VERVE HUMANCARE LABORATORIES AHI ARMSTRONG HEALTHCARE INC 2810 OPIATE ANTAGONISTS 2024-04-01 2026-03-31 IV 0 OPIATE ANTAGONISTS
41 71124 CISPLATIN 1MG/ML INJ (VEN) (BQ) CISPLATIN CISPLATIN 100ML BQ 29.19 29.1948 VIAL 0 VIAL VEN VENUS REMEDIES LIMITED AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS