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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 04935 HIPREX 1G TAB (PMA) HEXAMINE MANDELATE HEXAMINE MANDELATE HIPREX 20'S C 37.24 1.862 TAB 0 BOX PMA MORE PHARMA CORPORATION AHI ARMSTRONG HEALTHCARE INC 0836 URINARY ANTI-INFECTIVES 2024-04-01 2026-03-31 ORAL 0 URINARY ANTI-INFECTIVES
40 05027 AAP-NITROFURANTOIN 100MG TAB (APO/COL) NITROFURANTOIN AAP-NITROFURANTOIN 100'S A 17.86 0.18 TABLET 56 TAB APO APOTEX INC. COL COLLINS LTD 0836 URINARY ANTI-INFECTIVES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
42 05027 AAP-NITROFURANTOIN 100MG TAB (APO) NITROFURANTOIN AAP-NITROFURANTOIN 100'S A 18.21 0.18 TAB 56 BOTT APO APOTEX INC. COL AVENTA BARBADOS 0836 URINARY ANTI-INFECTIVES 2026-04-01 ORAL 0 URINARY ANTI-INFECTIVES
40 0502H PMS-NITROFURANTOIN 100MG TAB (PMS/COL) NITROFURANTOIN PMS-NITROFURANTOIN 100'S C 48.93 0.49 TABLET 0 TAB PMS PHARMASCIENCE COL COLLINS LTD 0836 URINARY ANTI-INFECTIVES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0502J AAP-NITROFURANTOIN 100MG TAB (APO) NITROFURANTOIN AAP-NITROFURANTOIN 100'S A 18.21 0.1821 TAB 56 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 0836 URINARY ANTI-INFECTIVES 2024-04-01 2026-03-31 ORAL 0 URINARY ANTI-INFECTIVES
42 0502M URIFON 100MG SR TAB (JLP) NITROFURANTOIN NITROFURANTOIN URIFON 10X10 A 15.63 0.16 TAB 28 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 0836 URINARY ANTI-INFECTIVES 2026-04-01 ORAL 0 URINARY ANTI-INFECTIVES
40 05216 ACTINOMYCIN D 500MCG INJ (KWA/ATB) ACTINOMYCIN D ACTINOMYCIN D 500MCG VIA BQ 36.70 36.70 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 05217 DACTINOTEC 500MCG INJ (UBI/RXP) ACTINOMYCIN D ACTINOMYCIN D DACTINOTEC 500MCG BQ 31.26 31.26 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 05218 ACTINOMYCIN D 500MCG INJ (CHC/ATB) ACTINOMYCIN D ACTINOMYCIN D 500MCG VIA BQ 33.16 33.16 INJECTION 0 VIAL CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 05219 ACTINOMYCIN D 500MCG INJ (ZUV) (BQ) ACTINOMYCIN D ACTINOMYCIN 500MCG BQ 14.71 14.7061 VIAL 10 VIAL ZUV ZUVIUS PHA PHARMACY SALES CARIBBEAN 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS
42 0521A ACTINOMYCIN D 500MCG INJ (KWA) DACTINOMYCIN DACTINOMYCIN ACTINOMYCIN D 500MCG VIA BQ 16.72 16.72 VIAL 0 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2026-04-01 Add to Contract IV 0 ANTINEOPLASTICS 2026-03-02
40 05313 APO-AZATHIOPRINE 50MG TAB (APO/COL) AZATHIOPRINE APO-AZATHIOPRINE 100'S A 28.60 0.29 TABLET 180 TAB APO APOTEX INC. COL COLLINS LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
40 0531A AZATHIOPRINE 50MG TAB (RPG/AHI) AZATHIOPRINE AZATHIOPRINE 100'S A 28.27 0.28 TABLET 180 TAB RPG RPG LIFE SCIENCES LTD AHI ARMSTRONG HEALTHCARE INC B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
42 0531A AZATHIOPRINE 50MG TAB (RPG) AZATHIOPRINE AZATHIOPRINE 100'S A 22.45 0.22 TAB 180 BLIS RPG RPG LIFE SCIENCES LTD AHI ARMSTRONG HEALTHCARE INC B 9244 IMMUNOSUPPRESSIVE AGENTS 2026-04-01 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
41 0531C IMUPRIN 50MG TAB (REM) AZATHIOPRINE AZATHIOPRINE IMUPRIN 10X10 A 9.84 0.0984 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
42 0531C IMUPRIN 50MG TAB (REM) AZATHIOPRINE AZATHIOPRINE IMUPRIN 10X10 A 16.72 0.17 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 9244 IMMUNOSUPPRESSIVE AGENTS 2026-04-01 ORAL 6 IMMUNOSUPPRESSIVE AGENTS
40 0531V IMURAN 50MG TAB (ASG/STO) AZATHIOPRINE AZATHIOPRINE IMURAN 100'S C 174.27 1.74 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
40 05415 BLEOMYCIN SULPHATE 15MG INJ (CIP/AHI) BLEOMYCIN SULPHATE BLEOMYCIN SULPHATE 15MG VIAL BQ 44.85 44.85 INJECTION 0 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
41 0541E BLEOMYCIN SULPHATE 15MG INJ (KWA) (BQ) BLEOMYCIN SULPHATE BLEOMYCIN SULPHATE 15MG VIAL BQ 34.01 34.0062 VIAL 30 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 IV 6 ANTINEOPLASTICS
42 0541M BLEOCHEM 15MG INJ (ZYD) BLEOMYCIN SULPHATE BLEOMYCIN SULPHATE BLEOCHEM 15MG VIAL BQ 41.10 41.10 VIAL 30 VIAL ZYD ZYDUS AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 IV/IM/SC 0 ANTINEOPLASTICS