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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 4141SG IBUPROFEN 400MG TAB (MPI) IBUPROFEN IBUPROFEN 10X10 A 8.7 0.087 TAB 120 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4141SP IBUSOL 400MG TAB (STL) IBUPROFEN IBUPROFEN IBUSOL 10X10 A 3.62 0.04 TAB 120 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4141SU DICLOFENAC SODIUM 50MG TAB (HEA) DICLOFENAC SODIUM DICLOFENAC SODIUM 10X10 A 2.61 0.03 TAB 42 BLIS HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2025-10-31
42 4141SY IBUPROFEN 400MG TAB (HEA) IBUPROFEN IBUPROFEN 10X10 C 8.89 0.09 TAB 120 BLIS HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2025-10-31
42 4141TD IBUQWIK 400MG TAB (JLP) IBUPROFEN IBUPROFEN IBUQWIK 200'S A 14.41 0.07 TAB 120 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4141TE INDICID 25MG TAB (JLP) INDOMETHACIN INDOMETHACIN INDICID 100'S C 27.18 0.27 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4141TH IBUPROFEN 400MG TAB (HEA) IBUPROFEN IBUPROFEN 10X10 C 8.89 0.09 TAB 120 BLIS HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-01-26
42 4141TJ DICLOFENAC SODIUM 50MG TAB (HEA) DICLOFENAC SODIUM DICLOFENAC 10X10 A 2.61 0.03 TAB 42 BLIS HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-01-26
42 4141TK IBUPROFEN 400MG TAB (HEA) (C) IBUPROFEN IBUPROFEN 10X10 C 8.89 0.09 TAB 120 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-02-27
42 4141TL DICLOFENAC 50MG TAB (HEA) DICLOFENAC SODIUM DICLOFENAC 10X10 A 2.61 0.03 TAB 42 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-02-27
40 4141TV DICLOFENAC SOD 50MG TAB (HEA/ATB) DICLOFENAC SODIUM DICLOFENAC SODIUM 10X10 A 2.64 0.0264 TABLET IMMED HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-12-07 2024-03-31 Change Local Agent oral 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-11-25
40 4141ZJ APO-DICLO 25MG TAB (APO/COL) DICLOFENAC SODIUM APO-DICLO 100'S A 9.70 0.10 TABLET 100 TAB APO APOTEX INC. COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 4141ZJ APO-DICLO 25MG TAB (APO) DICLOFENAC SODIUM APO-DICLO 100'S A 8.86 0.09 TAB 100 BOTT APO APOTEX INC. COL AVENTA BARBADOS 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS/COL) DICLOFEN DICLOFENAC SODIUM VOLTAREN 5X3ML C 20.99 4.20 INJECTION 0 AMP NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 IV/IM 0 CENTRAL NERVOUS SYSTEM DRUGS
41 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS) DICLOFE (C) DICLOFENAC SODIUM VOLTAREN 5X3ML C 20.99 4.1971 AMP 0 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 IV/IM 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS) DICLOFE DICLOFENAC SODIUM VOLTAREN 5X3ML C 20.99 4.20 AMPG 0 AMP NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 IV/IM 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 4142AY DICLOFENAC SOD 25MG/ML IV/IM INJ (MON/PHA) DICLOFENAC SODIUM DICLOFENAC SOD 10X3ML B 6.06 0.61 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 IV/IM 0 CENTRAL NERVOUS SYSTEM DRUGS
41 4142BL DICLOFENAC SOD 25MG/ML IV/IM INJ (C (B) DICLOFENAC SODIUM DICLOFENAC SOD 10X3ML B 4 0.3996 AMP 0 BOX CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 IV/IM 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4142BM DICLOFENAC SODIUM 25MG/ML INJ (BAX) DICLOFENAC SODIUM DICLOFENAC SODIUM 10X3ML B 3.37 0.34 VIAL 0 VIAL BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 IV/IM 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4142BR DICLOFENAC SODIUM 25MG/ML IV/IM INJ (MON) DICLOFENAC SODIUM DICLOFENAC SODIUM 10X3ML B 2.15 0.22 AMPG 0 AMP MON MONTAGE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 IV/IM 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS