Displaying 1 - 20 of 63
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 05415 BLEOMYCIN SULPHATE 15MG INJ (CIP/AHI) BLEOMYCIN SULPHATE BLEOMYCIN SULPHATE 15MG VIAL BQ 44.85 44.85 INJECTION 0 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0884AJ ASTHALIN 5MG/ML RESP SOL (CIP/AHI) SALBUTAMOL SALBUTAMOL ASTHALIN 15ML A 2.91 2.91 RESPIRATORY 20 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2022-04-01 2024-03-31 INHALATION 6 RESPIRATORY TRACT AGENTS
41 0884AJ ASTHALIN 5MG/ML RESP SOL (CIP) SALBUTAMOL SALBUTAMOL ASTHALIN 15ML A 1.96 1.9572 BOTT 20 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2024-04-01 2026-03-31 INHALATION 6 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA
42 0884AJ ASTHALIN 5MG/ML RESP SOL (CIP) SALBUTAMOL SALBUTAMOL ASTHALIN 15ML A 2.07 2.07 BOTT 20 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2026-04-01 INHALATION 6 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA
40 0884BL IPRAVENT 0.25MG/ML RESP SOL (CIP/AHI) IPRATRO IPRATROPIUM BROMIDE IPRAVENT 20X2ML A 32.70 1.64 RESPIRATORY 1 AMP CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2022-04-01 2024-03-31 Nasal 6 RESPIRATORY TRACT AGENTS
40 0884BT IPRAVENT 0.25MG/ML RESP SOL (CIP/AHI) IPRATRO IPRATROPIUM BROMIDE IPRAVENT 15ML A 1.82 1.82 RESPIRATORY 1 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2022-04-01 2024-03-31 Nasal 6 RESPIRATORY TRACT AGENTS
41 0884BT IPRAVENT 0.25MG/ML RESP SOL (CIP) IPRATROPIUM IPRATROPIUM IPRAVENT 15ML A 6.5 6.4968 BOTT 1 BOTT CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2024-04-01 2026-03-31 NASAL 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
42 09122 IPRAVENT 0.25MG/ML RESP SOL (CIP) IPRATROPIUM IPRATROPIUM IPRAVENT 15ML A 3.23 3.23 BOTT 1 BOTT CIP CIPLA LTD ARMSTRONG HEALTHCARE INC B 481208 ANTICHOLINERGIC AGENTS (RESPIRATORY) 2026-04-01 ORAL INHALATION 6 ANTICHOLINERGIC AGENTS (RESPIRATORY)
40 11529 GEMFIBROZIL 600MG TAB (CIP/AHI) GEMFIBROZIL GEMFIBROZIL 60'S B 40.86 0.68 TABLET 60 TAB CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 11529 GEMFIBROZIL 600MG TAB (CIP) GEMFIBROZIL GEMFIBROZIL 60'S B 40.86 0.6809 TAB 60 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2024-04-01 2026-03-31 ORAL 6 FIBRIC ACID DERIVATIVES
42 11529 GEMFIBROZIL 600MG TAB (CIP) GEMFIBROZIL GEMFIBROZIL 60'S C 40.91 0.68 TAB 60 BLIS CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 240606 FIBRIC ACID DERIVATIVES 2026-04-01 ORAL 6 FIBRIC ACID DERIVATIVES
40 1183G METOPROLOL 1MG/ML INJ (CIP/AHI) METOPROLOL METOPROLOL 5X5ML BQ 13.21 2.64 INJECTION 0 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
41 1183G METOLAR 1MG/ML INJ (CIP) METOPROLOL METOPROLOL METOLAR 5X5ML BQ 13.21 2.6422 VIAL 0 BOX CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS
40 2451AF LOPERAMIDE 2MG CAP (CIP/AHI) LOPERAMIDE LOPERAMIDE 30X10 A 27.94 0.09 CAPSULE 30 CAP CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 5608 ANTIDIARRHEA AGENTS 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS
40 4463N DONEPEZIL 5MG TAB (CIP/AHI) DONEPEZIL DONEPEZIL 4X7'S A 8.05 0.2875 TABLET IMMED 30 CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-11-29 2024-03-31 Add to Contract as Cat A oral 6 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-11-29
40 4981D DACARBAZINE 200MG INJ (CIP/AHI) DACARBAZINE DACARBAZINE 200MG VIAL BQ 23.02 23.02 INJECTION 0 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 5062AB REHYDRATION SALTS (CIP/AHI) REHYDRATION SALTS REHYDRATION SALTS 30'S A 17.91 0.60 10 SACH CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2022-04-01 2024-03-31 Oral 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 5062AF PROLYTE ORS PWDR (CIP) REHYDRATION SALTS REHYDRATION SALTS PROLYTE ORS 40'S A 23.92 0.598 BOX 10 SACH CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2024-04-01 2026-03-31 ORAL 0 REPLACEMENT THERAPY
42 5062AF PROLYTE ORS PWDR (CIP) REHYDRATION SALTS REHYDRATION SALTS PROLYTE ORS 40'S A 23.92 0.60 BOX 10 SACH CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2026-04-01 ORAL 0 REPLACEMENT THERAPY
40 51725 ALBENDAZOLE 40MG/ML SUSP (CIP/AHI) ALBENDAZOLE ALBENDAZOLE 10ML A 1.36 0.14 SUSPENSION 30 ML CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 0808 ANTHELMINTICS 2022-04-01 2024-03-31 Oral 1 ANTI-INFECTIVE AGENTS