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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
42 5232BF TERBINAFINE 1% LOTION (AUR) TERBINAFINE TERBINAFINE 30ML A 5.36 5.36 BOTT 1 BOTT AUR AUROCHEM LABORATORIES AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL
40 5232BJ KETOZAL 2% SHAMP (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 125ML C 10.47 0.08 SHAMPOO 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5232BJ KETOZAL 2% SHAMP (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 125ML C 11.58 0.0926 ML 100 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL
42 5232BJ KETOZAL 2% SHAMP (CAR) KETOCONAZOL (C) KETOCONAZOLE KETOZAL 125ML C 11.58 0.09 ML 100 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL
40 5232BN CANDID 1% EAR DR (GLP/ATB) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 15ML A 6.80 6.80 EAR DROP 1 BOTT GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 Change Local Agent OTIC 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 5232BP CANDID MOUTH PAINT 1% SOLN (GLP/ATB) CLOTRIMA CLOTRIMAZOLE CANDID MOUTH PAINT 20ML A 6.80 6.80 SOLUTION 2 BOTT GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 Change Local Agent TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 5232BS CANESTEN 1% CR (BSP/AHI) COTRIMAZOLE COTRIMAZOLE CANESTEN 15G A 9.27 9.27 CREAM TUBE BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2023-02-24 2024-03-31 Add to Contract as Cat A Topical ANTIFUNGALS TOPICAL 2023-02-24
41 5232BT CLOTRIMAZOLE 1% SOLN (CHC) CLOTRIMAZOLE CLOTRIMAZOLE 30ML A 2.12 2.1203 BOTT 2 BOTT CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5232BW KETOCONAZOLE 2% SHAMP (HEA) KETOCONAZOLE KETOCONAZOLE 100ML A 4.78 0.05 ML 100 BOTT HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 081404 ALLYAMINES 2026-04-01 2028-03-31 TOPICAL 6 ALLYAMINES 2025-10-31
42 5232BX KETOJOHN 2% LOT (JLP) KETOCONAZOLE KETOCONAZOLE KETOJOHN 30ML A 1.82 1.82 BOTT 2 BOTT JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5232BY KETOCONAZOLE 2% SHAMP (HEA) KETOCONAZOLE KETOCONAZOLE 100ML A 4.78 0.05 ML 100 BOTT HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL 2026-01-26
42 5232BZ KETOCONAZOLE 2% SHAMP (HEA) KETOCONAZOLE KETOCONAZOLE 100ML A 4.78 0.05 ML 100 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL 2026-02-27
40 5232ZA CANDID MOUTH PAINT 1% SOLN (GLP/ALI) CLOTRIMA CLOTRIMAZOLE CANDID MOUTH PAINT 20ML A 6.80 6.80 SOLUTION 2 BOTT 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
41 5232ZT NIZORAL 2% SHAMP (JAC) KETOCONAZOLE (C) KETOCONAZOLE NIZORAL 100ML C 26.45 0.2645 ML 100 BOTT JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL
42 5232ZT NIZORAL 2% SHAMP (JAC) KETOCONAZOL (C) KETOCONAZOLE NIZORAL 100ML C 27.75 0.28 ML 100 BOTT JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 6 ANTIFUNGALS TOPICAL
40 5232ZZ KETOCONAZOLE 2% SHAMP (HEA/ATB) KETOCONAZOLE KETOCONAZOLE 100 ML A 4.84 0.0484 SHAMPOO HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-12-07 2024-03-31 Change Local Agent Topical 6 ANTIFUNGALS TOPICAL 2022-11-25
41 5232ZZ KETOCONAZOLE 2% SHAMP (HEA) KETOCONAZOLE KETOCONAZOLE 100ML A 4.89 0.0489 ML 100 BOTT HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 Topical 6 ANTIFUNGALS TOPICAL
42 52333 CANDID 1% PWDR (GLP) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 100G A 5.44 5.44 BOTT 1 BOTT GLP GLENMARK PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 2028-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5233AD CANDID 1% PWDR (GLP/ALI) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 100G A 7.61 7.61 POWDER 1 BOTT 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 5233AF CANDID 1% PWDR (GLP/ATB) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 100G A 7.61 7.61 POWDER 1 BOTT GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 Change Local Agent TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22