Displaying 1 - 20 of 469
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 0012FA LORATADINE 10MG TAB (AUR/AHI) LORATADINE LORATADINE 100'S A $8.26 $0.08 TABLET 14 TAB AUR AUROCHEM LABORATORIES AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013AZ LEVOCETIRIZINE 2.5MG/ML SYR (CIR/AHI) LEVOCETIRIZINE LEVOCETIRIZINE 60ML C $5.71 $0.10 SYRUP 0 ML CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013BP CLARITINE 10MG TAB (BSP/AHI) LORATADINE (C) LORATADINE CLARITINE 30'S C $9.51 $0.32 TABLET CONTR BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 408 SECOND GENERATION ANTIHISTAMINES 2023-02-21 2023-04-07 Add to Contract as Cat C Oral SECOND GENERATION ANTIHISTAMINES 2023-02-24
40 0051F CAPECITABINE 150MG TAB (INP/AHI) CAPECITABINE CAPECITABINE 6X10 BQ $194.20 $3.24 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
40 00521 XELODA 500MG TAB (ROC/AHI) CAPECITABINE CAPECITABINE XELODA 120'S C $326.20 $2.72 TABLET 0 TAB ROC ROCHE SERVICIOS S.A. AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
40 00939 GRISEOFULVIN 25MG/ML SUSP (SUE/AHI) GRISEOFULVIN GRISEOFULVIN 120ML A $14.87 $0.12 SUSPENSION 500 ML SUE LABORATORIOS SUED S.R.L AHI ARMSTRONG HEALTHCARE INC 081492 ANTIFUNGALS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 0124R CHLORAMPHENICOL 0.5% EYE DR (CIR/AHI) CHLORAMPHENICOL CHLORAMPHENICOL 10ML A $1.90 $1.90 EYE DROP 1 BOTT CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0142B ERYTHROMYCIN 5% EYE OINT (AKI/AHI) ERYTHROMYCIN ERYTHROMYCIN 3.5G C $67.31 $67.31 EYE OINTMENT 0 TUBE AKI AKORN INC. AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0152BQ AMOXICILLIN 25MG/ML SUSP (MCP/AHI) AMOXICILLIN AMOXICILLIN 100ML A $1.79 $0.02 SUSPENSION 300 ML MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0155AG AMOXICILLIN 50MG/ML SUSP (MCP/AHI) AMOXICILLIN AMOXICILLIN 100ML A $1.93 $0.02 SUSPENSION 200 ML MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
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
40 0225H LACLOXA 500MG INJ (LDP/AHI) CLOXACILLIN CLOXACILLIN LACLOXA 500MG VIAL B $15.41 $15.41 INJECTION 0 VIAL LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2022-04-01 2022-09-30 IV 6 ANTI-INFECTIVE AGENTS 2022-03-29
40 0292J CLINEX 150MG CAP (ARP/AHI) CLINDAMYCIN HCL CLINDAMYCIN HYDROCHLORIDE CLINEX 3X10 A $9.65 $0.32 CAPSULE 28 CAP ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 08122820 LINCOMYCINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0294K CLINEX 300MG CAP (ARP/AHI) CLINDAMYCIN HCL CLINDAMYCIN HYDROCHLORIDE CLINEX 30'S A $18.76 $0.63 CAPSULE 28 CAP ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 08122820 LINCOMYCINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0302AA LACLIDA 150MG/ML INJ (LDP/AHI) CLINDAMYCIN PH CLINDAMYCIN PHOSPHATE LACLIDA 10X4ML BQ $79.86 $7.99 INJECTION 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 08122820 LINCOMYCINS 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
40 0314B FUSIDIC ACID DRESSING 1% (LDP/AHI) FUSIDIC ACID FUSIDIC ACID DRESSING 10'S A $19.14 $19.14 10 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 840404 ANTIBIOTICS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 03267 GENTAMICIN 0.3% EYE OINT (AKI/AHI) GENTAMICIN GENTAMICIN 3.5G C $156.87 $156.87 EYE OINTMENT 0 TUBE AKI AKORN INC. AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 03628 ETHAMBUTOL 400MG TAB (MCP/AHI) ETHAMBUTOL ETHAMBUTOL 10X10 A $12.42 $0.12 TABLET 150 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081604 ANTITUBERCULOSIS AGENTS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 0372B ISONIAZID 300MG TAB (MCP/AHI) ISONIAZID ISONIAZID 10X10 A $8.37 $0.08 TABLET 30 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081604 ANTITUBERCULOSIS AGENTS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 0373E ISONIAZID 100MG TAB (MCP/AHI) ISONIAZID ISONIAZID 10X10 A $5.55 $0.06 TABLET 30 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081604 ANTITUBERCULOSIS AGENTS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS