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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
41 35311 NATELE CAP (BSP) MULTIVITAMINS PRENATAL (C) MULTIVITAMINS PRENATAL NATELE 28'S C 12.59 0.4495 CAP 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
40 35313 VITAPLEX P CAP (CAR/COL) MULTIVITAMINS PRENATAL MULTIVITAMINS PRENATAL VITAPLEX P 400'S B 114.17 0.29 CAPSULE 0 CAP CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Oral 0 VITAMINS
41 35313 VITAPLEX P CAP (CAR) MULTIVITAMINS PRENATAL (B) MULTIVITAMINS PRENATAL VITAPLEX P 400'S B 121.65 0.3041 CAP 30 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
42 35313 VITAPLEX P CAP (CAR) MULTIVITAMINS PRENATAL MULTIVITAMINS PRENATAL VITAPLEX P 400'S B 121.65 0.30 CAP 30 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8828 MULTIVITAMIN PREPARATIONS 2026-04-01 2028-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
40 35314 NATELE TAB (BSP/COL) MULTIVITAMINS PRENATAL MULTIVITAMINS PRENATAL NATELE 28'S C 14.90 0.53 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Oral 0 VITAMINS
41 35314 NATELE TAB (BSP) MULTIVITAMINS PRENATAL (C) MULTIVITAMINS PRENATAL NATELE 28'S C 12.59 0.4495 TAB 0 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 0 MULTIVITAMIN PREPARATIONS
40 3532B VITAPLEX M SYR (CAR/COL) MULTIVITAMINS MULTIVITAMINS VITAPLEX M 250ML B 13.54 0.05 SYRUP 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Oral 0 VITAMINS
41 3532B VITAPLEX M SYR (CAR) MULTIVITAMINS (B) CALCIUM|CYANOCOBALAMIN|IODINE|IRON ELEMENTAL|MAGNESIUM|MANGANESE|NICOTINAMIDE|PH More ... VITAPLEX M 250ML B 14.41 0.0576 ML 150 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
42 3532B VITAPLEX M SYR (CAR) MULTIVITAMINSMULTIVITAMINS + MINERALS MULTIVITAMINSMULTIVITAMINS + MINERALS VITAPLEX M 250ML B 14.41 0.06 ML 250 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8828 MULTIVITAMIN PREPARATIONS 2026-04-01 2028-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
41 3541AB VITALUX PLUS TAB (ALC) MULTIVITAMINS (C) MULTIVITAMINS VITALUX PLUS 30'S C 28.62 0.9541 TAB 0 BOTT ALC ALCON LABORATORIES INC. AHI ARMSTRONG HEALTHCARE INC 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 0 MULTIVITAMIN PREPARATIONS
42 3541AC VITAMINS MULTI | TAB (KWA) MINERAL|MULTIVITAMIN MULTIVITAMIN|MINERALS MULTIVITAMIN|MINERALS 100'S B 15.60 0.16 TAB 0 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2026-04-01 2028-03-31 ORAL 0 MULTIVITAMIN PREPARATIONS 2026-03-02
40 35421 BECOPLEX CAP (CAR/COL) VITAMIN B COMPLEX VITAMIN B COMPLEX BECOPLEX 500'S B 89.27 0.18 CAPSULE 0 CAP CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8808 VITAMIN B COMPLEX 2022-04-01 2024-03-31 Oral 0 VITAMINS
41 35421 BECOPLEX CAP (CAR) VITAMIN B COMPLEX (B) VITAMIN B COMPLEX BECOPLEX 500'S B 98.68 0.1974 CAP 60 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8808 VITAMIN B COMPLEX 2024-04-01 2026-03-31 ORAL 6 VITAMIN B COMPLEX
42 35421 BECOPLEX CAP (CAR) VITAMIN B COMPLEX VITAMIN B COMPLEX BECOPLEX 500'S B 98.68 0.20 CAP 60 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8808 VITAMIN B COMPLEX 2026-04-01 2028-03-31 ORAL 6 VITAMIN B COMPLEX
40 35423 NEUROBION TAB (MEK/COL) VITAMIN B COMPLEX VITAMIN B COMPLEX NEUROBION 120'S C 47.57 0.40 TABLET 0 TAB MEK MERCK SERONO COL COLLINS LTD 8808 VITAMIN B COMPLEX 2022-04-01 2024-03-31 Oral 0 VITAMINS
40 35433 BECOPLEX SYR (CAR/COL) VITAMIN B COMPLEX VITAMIN B COMPLEX BECOPLEX 250ML B 11.66 0.05 SYRUP 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8808 VITAMIN B COMPLEX 2022-04-01 2024-03-31 Oral 0 VITAMINS
41 35433 BECOPLEX SYR (CAR) VITAMIN B COMPLEX (B) VITAMIN B COMPLEX BECOPLEX 250ML B 11.82 0.0473 ML 150 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8808 VITAMIN B COMPLEX 2024-04-01 2026-03-31 ORAL 6 VITAMIN B COMPLEX
42 35433 BECOPLEX SYR (CAR) VITAMIN B COMPLEX VITAMIN B COMPLEX BECOPLEX 250ML B 13.70 0.05 ML 150 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8808 VITAMIN B COMPLEX 2026-04-01 2028-03-31 ORAL 6 VITAMIN B COMPLEX
40 35444 NEUROBION INJ (MEK/COL) VITAMIN B COMPLEX VITAMIN B COMPLEX NEUROBION 1 DS SYRNG C 8.02 8.02 INJECTION 0 PFS MEK MERCK SERONO COL COLLINS LTD 8808 VITAMIN B COMPLEX 2022-04-01 2024-03-31 IV 0 VITAMINS
40 3544D IN FUVITE PAED INJ (BAX/STO) MULTIVITAMINS MULTIVITAMINS IN FUVITE PAED 5 PAIRS B 180.22 36.04 INJECTION 0 INJ BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Price Change IV 0 VITAMINS 2022-05-11