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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 A4021 COMBIVENT 0.2MG/ML|1MG/ML RESP SOL (BOE) IPRATROPIUM|SALBUTA IPRATROPIUM|SALBUTAMOL COMBIVENT 20X2.5ML A 69.15 3.46 AMPG 20 AMPG BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS 2026-04-01 2028-03-31 INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS
40 A411AN CARCA 25MG TAB (INP/AAL) CARVEDILOL CARVEDILOL CARCA 30'S A 2.17 0.07 TABLET 60 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-05-31 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS 2022-05-31
40 A411AP CARVEDILOL 25MG TAB (FSB/ATB) CARVEDILOL CARVEDILOL 28'S A 2.12 0.08 TABLET 60 TAB FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A411AP CARVEDILOL 25MG TAB (FSB) CARVEDILOL CARVEDILOL 28'S A 2.17 0.0777 TAB 60 BOX FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 A411AV CARVEDILOL 25MG TAB (MCP/AHI) CARVEDILOL CARVEDILOL 3X10 A 2.26 0.0753 TABLET 60 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A411BA CARVEDILOL 25MG TAB (KWA) CARVEDILOL CARVEDILOL 28'S A 2.5 0.0893 TAB 60 BOTT KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A411BB CARVEDI-DENK 25MG TAB (EDK) CARVEDILOL CARVEDILOL CARVEDI-DENK 30'S C 6.12 0.20 TAB 60 BLIS EDK DENK PHARMA GMBH & CO. KG. SBI MASSY DISTRIBUTION (BDOS) LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A411BP CARVENIM 25MG TAB (ANC) CARVEDILOL CARVEDILOL CARVENIM 3X10 A 1.77 0.06 TAB 60 BLIS ANC AEONIM HEALTHCARE SBI MASSY DISTRIBUTION (BDOS) LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A411BS CARWIN 25MG TAB (TPP) CARVEDILOL CARVEDILOL CARWIN 100'S A 4.35 0.04 TAB 60 BLIS TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A411EW CARVEDI-DENK 25MG TAB (EDK) CARVEDI CARVEDILOL CARVEDI-DENK 30'S C 6.12 0.20 TAB 60 BLIS EDK DENK PHARMA GMBH & CO. KG. COL AVENTA BARBADOS B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
41 A411J CARCA 25MG TAB (INP) CARVEDILOL CARVEDILOL CARCA 30'S A 2.36 0.0788 TAB 60 BOX INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 A411L CARDOZ 25MG TAB (IPC/ATB) CARVEDILOL CARVEDILOL CARDOZ 28'S A 2.77 0.10 TABLET 60 TAB IPC IPCA Laboratories Ltd. ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 A412AM CARCA 12.5MG TAB (INP/AAL) CARVEDILOL CARVEDILOL CARCA 30'S A 1.52 0.05 TABLET 60 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-05-31 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS 2022-05-31
40 A412AN CARVEDILOL 12.5MG TAB (FSB/ATB) CARVEDILOL CARVEDILOL 28'S A 1.63 0.06 TABLET 60 TAB FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 A412AN CARVEDILOL 12.5MG TAB (FSB) CARVEDILOL CARVEDILOL 28'S A 2.04 0.0728 TAB 60 BOX FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 A412AT CARVEDILOL 12.5MG TAB (MCP/AHI) CARVEDILOL CARVEDILOL 3X10 A 2.83 0.09 TABLET 60 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 A412AT CARVEDILOL 12.5MG TAB (MCP) CARVEDILOL CARVEDILOL 12.5MG TAB 30'S A $2.26 $0.07533 TABLETS TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 2424 2023-06-06 2024-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS 2023-06-09
42 A412BH CARVENIM 12.5MG TAB (ANC) CARVEDILOL CARVEDILOL CARVENIM 3X10 A 1.17 0.04 TAB 60 BLIS ANC AEONIM HEALTHCARE SBI MASSY DISTRIBUTION (BDOS) LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2026-04-01 2028-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
42 A412BM CARWIN 12.5MG TAB (TPP) CARVEDILOL CARVEDILOL CARWIN 100'S A 3.78 0.04 TAB 60 BLIS TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC B 2408 HYPOTENSIVE AGENTS 2026-04-01 2028-03-31 ORAL 6 HYPOTENSIVE AGENTS
41 A412J CARCA 12.5MG TAB (INP) CARVEDILOL CARVEDILOL CARCA 30'S A 1.58 0.0526 TAB 60 BOX INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS