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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
40 A061C FLUDARABINE 50MG INJ (INP/AHI) FLUDARABINE FLUDARABINE 50MG VIAL BQ 134.61 134.61 INJECTION 0 VIAL INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
42 A061F FLUDARABINE 50MG INJ (KWA) FLUDARABINE FLUDARABINE 50MG VIAL BQ 626.93 626.93 VIAL 0 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2026-04-01 2028-03-31 IV 0 ANTINEOPLASTICS 2026-03-02
40 A0811 PNEUMOVAX 23 INJ (MSD/STO) PNEUMOCOCCAL STREPTOCOCCUS PNEUMONIA TYPES PNEUMOVAX 0.5ML VIAL C 23.98 23.98 INJECTION 0 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 8012 VACCINES 2022-07-26 2024-03-31 Package Size Change IM SERUMS, TOXOIDS AND VACCINES 2022-07-26
41 A0811 PNEUMOVAX 23 INJ (MSD) PNEUMOCOCCAL STREPTOCOCCUS PNEUMONIA TYPES PNEUMOVAX 0.5ML VIAL B 24.68 24.6824 VIAL 1 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 8012 VACCINES 2024-04-01 2026-03-31 IM 0 VACCINES
40 A0814 PNEUMOVAX 23 25MCG INJ (MSD/STO) PNEUMOCOCCAL PNEUMOCOCCAL PNEUMOVAX 23 10X0.5ML B 239.78 23.98 INJECTION 0 AMP MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 8012 VACCINES 2022-04-01 2024-03-31 IV 0 SERUMS, TOXOIDS AND VACCINES
40 A0825 PREVNAR 13 16MCG INJ (PFI/STO) PNEUMOCOCCAL STREPTOCOCCUS PNEUMONIA TYPES PREVNAR 13 1 DOSE B 176.23 176.23 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 8012 VACCINES 2022-04-01 2022-06-21 IV 0 SERUMS, TOXOIDS AND VACCINES
40 A0825 PREVNAR 13 16MCG INJ (PFI/STO) PNEUMOCOCCAL STREPTOCOCCUS PNEUMONIA TYPES PREVNAR 13 1 DOSE B 223.12 223.12 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 8012 VACCINES 2022-06-22 2024-03-31 Price Change IV 0 SERUMS, TOXOIDS AND VACCINES 2022-06-22
41 A0825 PREVNAR 13 16MCG INJ (PFI) PNEUMOCOCCAL STREPTOCOCCUS PNEUMONIA TYPES PREVNAR 13 1 DOSE B 177.94 177.9415 VIAL 1 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 8012 VACCINES 2024-04-01 2026-03-31 IV 0 VACCINES
42 A0825 PREVNAR 13 16MCG INJ (PFI) STREPTOCOCCUS PNEUMONIA TYPES STREPTOCOCCUS PNEUMONIA TYPES PREVNAR 13 0.5ML PFS B 177.94 177.94 PFS 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 8012 VACCINES 2026-04-01 2028-03-31 IV 0 VACCINES
40 A101L LABETALOL 5MG/ML INJ (MON/PHA) LABETALOL LABETALOL 20ML B 8.67 8.67 INJECTION 0 VIAL MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
42 A101L LABETALOL 5MG/ML INJ (MON) LABETALOL LABETALOL 20ML B 4.65 4.65 VIAL 0 VIAL MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS
40 A101M LABETALOL 5MG/ML INJ (KWA/ATB) LABETALOL LABETALOL 20ML AMP B 4.05 4.05 INJECTION 0 AMP KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 CARDIOVASCULAR DRUGS
41 A101T LABETALOL 5MG/ML INJ (LDP) (B) LABETALOL LABETALOL 20ML B 7.09 7.0948 AMP 0 AMP LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS
41 A101U LABETALOL 5MG/ML INJ (FSB) (B) LABETALOL LABETALOL 20ML VIAL B 4.95 4.9473 VIAL 0 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS
42 A101X LABETALOL 5MG/ML INJ (FSB) LABETALOL LABETALOL 20ML VIAL B 4.43 4.43 VIAL 0 FSB FLAGSHIP BIOTECH STO BRYDEN STOKES LTD 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 IV 0 BETA ADRENERGIC BLOCKING AGENTS 2026-03-05
40 A1022 APO-LABETALOL 100MG TAB (APO/COL) LABETALOL APO-LABETALOL 100'S A 54.37 0.54 TABLET 90 TAB APO APOTEX INC. COL COLLINS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 A1022 APO-LABETALOL 100MG TAB (APO) LABETALOL APO-LABETALOL 100'S A 55.45 0.55 TAB 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 A102D LABETALOL 100MG TAB (LDP/AHI) LABETALOL LABETALOL 100'S A 67.93 0.68 TABLET 90 TAB LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2022-09-30 Oral 6 CARDIOVASCULAR DRUGS 2022-03-29
41 A102F APO-LABETALOL 100MG TAB (APO) LABETALOL APO-LABETALOL 100'S A 55.45 0.5545 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A102L LIBETOR 100MG TAB (JLP) LABETALOL LABETALOL LIBETOR 10X10 A 23.92 0.24 TAB 90 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS