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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 5231AY NIZORAL 2% CR (JAC) KETOCONAZOLE (C) KETOCONAZOLE NIZORAL 40G C 22.26 22.2631 TUBE 2 BOX JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231BA KETOZAL 2% CR (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 15G C 3.26 3.26 CREAM 0 TUBE CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231BA KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 15G C 3.48 3.4795 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231BA KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 15G C 3.48 3.48 TUBE 2 TUBE CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231BU CLOTRIMAZOLE 1% CR (HEA/RXP) CLOTRIMAZOLE CLOTRIMAZOLE 15G A 1.44 1.44 CREAM 2 TUBE HEA HEALTH 2000 INC RXP RX PRO INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5231BV KETOCONAZOLE 2% CR (HEA/RXP) KETOCONAZOLE KETOCONAZOLE 15G A 1.90 1.90 CREAM 2 TUBE HEA HEALTH 2000 INC RXP RX PRO INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5231CC KETOCONAZOLE 2% CR (HEA/ATB) KETOCONAZOLE KETOCONAZOLE 15G A 1.9 1.9 CREAM HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-12-07 2024-03-31 Change Local Agent Topical 0 ANTIFUNGALS TOPICAL 2022-11-25
41 5231CC KETOCONAZOLE 2% CR (HEA) KETOCONAZOLE KETOCONAZOLE 15G A 1.96 1.9572 TUBE 2 TUBE HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 Topical 0 ANTIFUNGALS TOPICAL
41 5231CE CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.3453 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231CE CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.35 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL 2026-02-11
42 5231CH CANDID 1% CREAM (GLP) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 20G A 1.09 1.09 TUBE 2 TUBE GLP GLENMARK PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231CV LAMISIL 1% CR (GSK/COL) TERBINAFINE TERBINAFINE LAMISIL 15G C 15.47 15.47 CREAM 0 TUBE GSK GLAXOSMITHKLINE COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231CV LAMISIL 1% CR (GSK) TERBINAFINE (C) TERBINAFINE LAMISIL 15G C 16.26 16.2556 TUBE 2 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231CW LAMISIL 1% GEL (GSK/COL) TERBINAFINE TERBINAFINE LAMISIL 15G C 17.32 17.32 GEL 0 TUBE GSK GLAXOSMITHKLINE COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231CW LAMISIL 1% GEL (GSK) TERBINAFINE (C) TERBINAFINE LAMISIL 15G C 18.19 18.1856 TUBE 0 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231DU CELAMINA 1% CR (GLP/ALI) CICLOPIROX OLAMINE CICLOPIROX OLAMINE CELAMINA 20G A 6.80 6.80 CREAM 2 TUBE GLP GLENMARK PHARMACEUTICALS LTD ALI ALL HEALTH INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2022-03-22 Delete from contract TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 5231EB ECONAZOLE 1% CR (KWA/ATB) ECONAZOLE ECONAZOLE 15G A 2.56 2.56 CREAM 2 TUBE KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5231ED CANESTEN 1% CR (BSP/COL) CLOTRIMAZOLE CLOTRIMAZOLE CANESTEN 15G C 8.97 8.97 CREAM 0 TUBE BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231ED CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.3453 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231ED CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 6.69 6.69 TUBE 2 TUBE BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL