Displaying 1 - 20 of 72
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 0211AK ERTAPENEM 1G INJ (SLS/AHI) ERTAPENEM ERTAPENEM 1G VIAL BQ 22.02 22.02 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
41 0212AR IMIPENEM|CILASTATIN 500MG|500MG INJ (SLS) CILASTATIN|IMIPENE (BQ) CILASTATIN|IMIPENEM IMIPENEM|CILASTATIN 500MG VIAL BQ 27.56 27.5638 VIAL 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 08120708 CARBAPENEMS 2024-04-01 2026-03-31 IV 0 CARBAPENEMS
41 0603D FLUOROURACIL 50MG/ML INJ (SLS (BQ) FLUOROURACIL FLUOROURACIL 10ML BQ 18.67 18.6749 VIAL 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 0 ANTINEOPLASTICS
42 0603D FLUOROURACIL 50MG/ML INJ (SLS FLUOROURACIL FLUOROURACIL 10ML BQ 3.43 3.43 VIAL 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 IV 0 ANTINEOPLASTICS
40 0621B MERCAPTOPURINE 50MG TAB (SLS/AHI) MERCAPTOPURINE MERCAPTOPURINE 30'S A 45.64 1.52 TABLET 60 TAB SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 0621B MERCAPTOPURINE 50MG TAB (SLS) MERCAPTOPURINE MERCAPTOPURINE 30'S A 45.64 1.5214 TAB 60 BOX SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
42 0621B MERCAPTOPURINE 50MG TAB (SLS) MERCAPTOPURINE MERCAPTOPURINE 30'S A 45.64 1.52 TAB 60 BLIS SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2026-04-01 ORAL 6 ANTINEOPLASTICS
40 0702C PYRIDOSTIGMINE 60MG TAB (SLS/AHI) PYRIDOSTIGMINE PYRIDOSTIGMINE 50'S A 31.10 0.62 TABLET 180 TAB SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 Oral 6 AUTONOMIC DRUGS
40 0801P DOPAMINE 40MG/ML INJ (SLS/AHI) DOPAMINE DOPAMINE 25X5ML B 35.47 1.42 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0801P DOPAMINE 40MG/ML INJ (SLS) (B) DOPAMINE DOPAMINE 25X5ML B 40.37 1.6147 VIAL 0 BOX SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC AGONIST
42 0801P DOPAMINE 40MG/ML INJ (SLS) DOPAMINE DOPAMINE 25X5ML BQ 51.38 2.06 VIAL 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2026-04-01 IV 0 BETA ADRENERGIC AGONIST
40 08234 ISOLIN 2MG/ML INJ (SLS/AHI) ISOPRENALINE ISOPRENALINE ISOLIN 5X1ML BQ 37.92 7.58 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 08234 ISOLIN 2MG/ML INJ (SLS) ISOPRENALINE (BQ) ISOPRENALINE ISOLIN 5X1ML BQ 37.92 7.5841 VIAL 1 BOX SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC AGONIST
42 08234 ISOLIN 2MG/ML INJ (SLS) ISOPRENALINE ISOPRENALINE ISOLIN 5X1ML BQ 38.17 7.63 VIAL 1 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121208 BETA ADRENERGIC AGONIST 2026-04-01 IV 0 BETA ADRENERGIC AGONIST
40 0951L SUXAMETHONIUM 50MG/ML INJ (SLS/AHI) SUXAMETHONIUM SUXAMETHONIUM 10X10ML B 43.11 4.31 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
40 10415 PROTAMINE SULPHATE 10MG/ML INJ (SLS/AHI) PROTAMINE SULPHATE PROTAMINE SULPHATE 25X5ML B 235.27 9.41 INJECTION 0 AMP SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 202808 ANTIHEPARIN 2022-04-01 2024-03-31 IV 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 10415 PROTAMINE SULPHATE 10MG/ML INJ (SLS) (B) PROTAMINE SULPHATE PROTAMINE SULPHATE 25X5ML B 235.27 9.4108 AMP 20 BOX SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 202808 ANTIHEPARIN 2024-04-01 2026-03-31 IV 0 ANTIHEPARIN
40 10518 AMINOCAPROIC ACID 250MG/ML INJ (SLS/AHI) AMINOCAPROIC ACID AMINOCAPROIC ACID 20ML BQ 20.09 20.09 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 202816 HEMOSTATICS 2022-04-01 2024-03-31 IV 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 10518 AMINOCAPROIC ACID 250MG/ML INJ (SLS (BQ) AMINOCAPROIC ACID AMINOCAPROIC ACID 20ML BQ 20.2 20.1971 VIAL 10 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 202816 HEMOSTATICS 2024-04-01 2026-03-31 IV 0 HEMOSTATICS
42 10518 AMINOCAPROIC ACID 250MG/ML INJ (SLS AMINOCAPROIC ACID AMINOCAPROIC ACID 20ML BQ 20.25 20.25 VIAL 10 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 202816 HEMOSTATICS 2026-04-01 IV 0 HEMOSTATICS