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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 0153BK AMOXAPEN 500MG CAP (REM) AMOXICILLIN AMOXICILLIN AMOXAPEN 100X10 A 121.78 0.1218 CAP 56 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 081216 PENICILLINS 2024-04-01 2026-03-31 ORAL 0 PENICILLINS
40 0153C AMOXAPEN 500MG CAP (REM/SBI) AMOXICILLIN AMOXICILLIN AMOXAPEN 100x10 C 115.83 0.12 CAPSULE 0 CAP REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0153CC AMOXIL 500MG CAP (GSK/COL) AMOXICILLIN AMOXICILLIN AMOXIL 100'S C 42.41 0.42 CAPSULE 0 CAP GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0153CC AMOXIL 500MG CAP (GSK) AMOXICILLIN (C) AMOXICILLIN AMOXIL 100'S C 46.65 0.4665 CAP 56 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2024-04-01 2026-03-31 ORAL 0 PENICILLINS
42 0153CC AMOXIL 500MG CAP (GSK) AMOXICILLIN (C) AMOXICILLIN AMOXIL 100'S C 48.98 0.49 CAP 56 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS 081216 PENICILLINS 2026-04-01 ORAL 0 PENICILLINS
40 0153CS AMOXICILLIN 500MG CAP (FSB/ATB) AMOXICILLIN AMOXICILLIN 1000'S A 72.04 0.07 CAPSULE 28 CAP FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0153CW AMOXAPEN 500MG CAP (REM/SBI) AMOXICILLIN AMOXICILLIN AMOXAPEN 10x10 C 10.14 0.10 CAPSULE 0 CAP REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0153CW AMOXAPEN 500MG CAP (REM) AMOXICILLI AMOXICILLIN AMOXAPEN 10x10 A 12.64 0.1264 CAP 56 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 0812 ANTIBACTERIALS 2024-04-01 2026-03-31 ORAL 0 ANTIBACTERIALS
42 0153CW AMOXAPEN 500MG CAP (REM) AMOXICILLI AMOXICILLIN AMOXAPEN 10x10 A 24.46 0.24 CAP 56 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 0812 ANTIBACTERIALS 2026-04-01 ORAL 0 ANTIBACTERIALS
41 0153DH AMOXICILLIN 500MG TAB (MCP) AMOXICILLIN AMOXICILLIN 10X10 A 10.03 0.1003 CAP 28 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 0812 ANTIBACTERIALS 2024-04-01 2024-12-27 ORAL 0 ANTIBACTERIALS 2023-10-30
41 0153DH AMOXICILLIN 500MG TAB (MCP) AMOXICILLIN AMOXICILLIN 10X10 A 11.4 0.114 CAP 28 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 0812 ANTIBACTERIALS 2024-12-28 2026-03-31 ORAL 0 ANTIBACTERIALS 2024-12-27
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
41 0155AG AMOXICILLIN 50MG/ML SUSP (MCP) AMOXICILLIN AMOXICILLIN 100ML A 2.01 0.0201 ML 200 BOTT MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2024-04-01 2026-03-31 ORAL 0 PENICILLINS
42 0155AR AMOTID 50MG/ML SUSP (BEX) AMOXICILLIN AMOXICILLIN AMOTID 100ML A 2.58 0.03 ML 200 BOTT BEX BEXIMCO PHARMACEUTICALS LTD RXP RX PRO INC 081216 PENICILLINS 2026-04-01 ORAL 0 PENICILLINS
40 0155T AMOXIL 50MG/ML SUSP (GSK/COL) AMOXICILLIN AMOXICILLIN AMOXIL 100ML C 13.27 0.13 SUSPENSION 0 ML GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0155T AMOXIL 50MG/ML SUSP (GSK) AMOXICILLIN (C) AMOXICILLIN AMOXIL 100ML C 14.6 0.146 ML 200 BOTT GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2024-04-01 2026-03-31 ORAL 0 PENICILLINS
40 0164AM AMPICILLIN 500MG INJ (KWA/ATB) AMPICILLIN AMPICILLIN 500MG VIAL BQ 0.90 0.90 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 081216 PENICILLINS 2022-04-01 2022-09-30 IV 0 ANTI-INFECTIVE AGENTS 2022-03-30
42 0164AR AMPICILLIN 500MG INJ (MON) AMPICILLIN AMPICILLIN 10X5ML B 13.18 1.32 VIAL 28 VIAL MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2026-04-01 IV 0 PENICILLINS
40 0164AU AMPICILLIN 500MG INJ (CHC/ATB) AMPICILLIN AMPICILLIN 500MG VIAL BQ 0.82 0.82 INJECTION 0 VIAL CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Price Change IV 6 ANTI-INFECTIVE AGENTS 2021-12-03
40 0164AW AMPICILLIN 500MG INJ (MON/PHA) AMPICILLIN AMPICILLIN 500MG VIAL C 1.69 1.69 INJECTION 0 VIAL MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS