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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 6651A NATRILIX SR 1.5MG SR TAB (SER) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 6.17 0.2057 TABSR 30 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 402824 THIAZIDE LIKE DIURETICS 2024-04-01 2026-03-31 ORAL 6 THIAZIDE LIKE DIURETICS
42 6651A NATRILIX SR 1.5MG SR TAB (SER) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 6.17 0.21 TAB 30 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 402824 THIAZIDE LIKE DIURETICS 2026-04-01 2028-03-31 ORAL 6 THIAZIDE LIKE DIURETICS
40 6651AJ NATRILIX SR 1.5MG TAB (SER/COL) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 5.98 0.20 TABLET 30 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD B 402824 THIAZIDE LIKE DIURETICS 2022-04-01 2024-03-31 Oral 6 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 6651AJ NATRILIX SR 1.5MG SR TAB (SER) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 6.17 0.2057 TABSR 30 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD B 402824 THIAZIDE LIKE DIURETICS 2024-04-01 2026-03-31 ORAL 6 THIAZIDE LIKE DIURETICS
42 6651AJ NATRILIX SR 1.5MG SR TAB (SER) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 6.17 0.21 TAB 30 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS B 402824 THIAZIDE LIKE DIURETICS 2026-04-01 2028-03-31 ORAL 6 THIAZIDE LIKE DIURETICS
40 6651AL INALIX SR 1.5MG TAB (HEA/ATB) INDAPAMIDE (C) INDAPAMIDE INALIX SR 3X10 C 2.91 0.097 TABLET SUSTA HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD B 402824 THIAZIDE LIKE DIURETICS 2022-12-07 2024-03-31 Change Local Agent oral 0 THIAZIDE LIKE DIURETICS 2022-11-25
42 6651AP INALIX 1.5MG SR TAB (HEA) INDAPAMIDE INDAPAMIDE INALIX 3X10 C 2.91 0.10 TAB 30 BLIS HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC B 402824 THIAZIDE LIKE DIURETICS 2026-04-01 2028-03-31 ORAL 6 THIAZIDE LIKE DIURETICS
40 66613 TAMBOCOR 100MG TAB (PMA/AHI) FLECAINIDE FLECAINIDE TAMBOCOR 25'S C 25.82 1.03 TABLET 0 TAB PMA MORE PHARMA CORPORATION AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 66615 FLECAINIDE 100MG TAB (ROL) (B) FLECAINIDE FLECAINIDE 60'S B 85.41 1.4235 TAB 90 BOX ROL ROXANE LABORATORIES INC. AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
40 66616 APO-FLECAINIDE 100MG TAB (APO/COL) FLECAINIDE APO-FLECAINIDE 100'S B 44.85 0.45 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 66616 APO-FLECAINIDE 100MG TAB (APO) FLECAINIDE APO-FLECAINIDE 100'S B 45.75 0.46 TAB 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS 240404 ANTIARRHYTHMIC AGENTS 2026-04-01 2028-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
41 6661D FLECAINIDE 100MG TAB (LDP) (B) FLECAINIDE FLECAINIDE 20'S B 26.94 1.3469 TAB 90 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
41 6661F APO-FLECAINIDE 100MG TAB (APO) (B) FLECAINIDE APO-FLECAINIDE 100'S B 45.75 0.4575 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
40 66721 CATAFLAM 1.8MG/ML SUSP (NVS/COL) DICLOFENAC P DICLOFENAC POTASSIUM CATAFLAM 120ML C 8.75 0.07 SUSPENSION 0 ML NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 66721 CATAFLAM 1.8MG/ML SUSP (NVS) DICLOFENAC (C) DICLOFENAC POTASSIUM CATAFLAM 120ML C 9.62 0.0802 ML 120 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2025-01-20 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-12-09
41 66725 DICLOFENAC POTASSIUM 1.8MG/ML SUSP (KWA) (C) DICLOFENAC POTASSIUM DICLOFENAC POTASSIUM 120ML C 4.81 0.0401 ML 120 BOTT KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 66731 CATAFLAM 25MG TAB (NVS/COL) DICLOFENAC POTASS DICLOFENAC POTASSIUM CATAFLAM 20'S A 8.86 0.44 TABLET 15 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 66731 CATAFLAM 25MG TAB (NVS) DICLOFENAC POTAS DICLOFENAC POTASSIUM CATAFLAM 20'S A 8.86 0.4431 TAB 15 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 66731 CATAFLAM 25MG TAB (NVS) DICLOFENAC POTAS DICLOFENAC POTASSIUM CATAFLAM 20'S A 8.86 0.44 TAB 15 BLIS NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
40 66739 CATAFLAM DISPERS 50MG TAB (NVS/COL) DICLOFENA DICLOFENAC POTASSIUM CATAFLAM DISPERS 12'S C 12.07 1.01 TABLET 0 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS