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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 A6715 SINGULAIR 4MG TAB (MSD) MONTELUKAST (C) MONTELUKAST SINGULAIR 30'S C 47.76 1.592 TAB 30 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
42 A6715 SINGULAIR 4MG TAB (MSD) MONTELUKAST MONTELUKAST SINGULAIR 30'S C 47.76 1.59 TAB 30 BLIS MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A671AA APO-MONTELUKAST 10MG TAB (APO/COL) MONTELUKAST APO-MONTELUKAST 30'S A 5.71 0.19 TABLET 30 TAB APO APOTEX INC. COL COLLINS LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 6 RESPIRATORY TRACT AGENTS
42 A671AA APO-MONTELUKAST 10MG TAB (APO) MONT MONTELUKAST APO-MONTELUKAST 30'S A 5.03 0.17 TAB 30 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A671AY BREATHEZY CHEWABLE 5MG TAB (MSN/AHI) MONTELUK MONTELUKAST BREATHEZY CHEWABLE 3X10 A 3.13 0.10 TABLET 30 TAB MSN MSN LABS AHI ARMSTRONG HEALTHCARE INC B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2022-09-30 Oral 6 RESPIRATORY TRACT AGENTS 2022-03-29
40 A671AZ BREATHEZY CHEWABLE 4MG TAB (MSN/AHI) MONTELUK MONTELUKAST BREATHEZY CHEWABLE 3X10 A 2.72 0.09 TABLET 30 TAB MSN MSN LABS AHI ARMSTRONG HEALTHCARE INC B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2022-09-30 Oral 6 RESPIRATORY TRACT AGENTS 2022-03-29
40 A671BA BREATHEZY 10MG TAB (MSN/AHI) MONTELUKAST MONTELUKAST BREATHEZY 3X10 A 5.44 0.18 TABLET 30 TAB MSN MSN LABS AHI ARMSTRONG HEALTHCARE INC B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2022-09-30 Oral 6 RESPIRATORY TRACT AGENTS 2022-03-29
41 A671CB BREATHEZY 10MG TAB (MSN) MONTELUKAS MONTELUKAST BREATHEZY 3X10 A 5.27 0.1758 TAB 30 BOX MSN MSN LABS ATB ANSA TRADING BARBADOS LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A671CE MONTELUKAST CHEWABLE 10MG TAB (TOR/AHI) MONTE MONTELUKAST MONTELUKAST CHEWABLE 90'S A 14.81 0.16 TABLET 30 TAB TOR TORRENT PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 6 RESPIRATORY TRACT AGENTS
41 A671CJ APO-MONTELUKAST CHEWABLE 4MG TAB (A MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.67 0.1223 TAB 30 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
41 A671CK APO-MONTELUKAST 10MG TAB (APO) MONT MONTELUKAST APO-MONTELUKAST 30'S A 5.03 0.1676 TAB 30 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
41 A671CL APO-MONTELUKAST CHEWABLE 5MG TAB (A MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.94 0.1314 TAB 30 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
42 A671CV GLEMONT 4MG CHEW TAB (GLP) MONTELUKAST MONTELUKAST GLEMONT 3X10 A 3.26 0.11 TAB 30 BLIS GLP GLENMARK PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
42 A671DE GLEMONT 4MG CHEW TAB (GLP) MONTELUKAST MONTELUKAST GLEMONT 30'S A 3.26 0.11 TAB 30 BLIS GLP GLENMARK PHARMACEUTICALS LTD CWS CAPSULE WHOLESALE B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
41 A671K PMS-MONTELUKAST CHEWABLE 4MG TAB (PMS) MONTELUKAST PMS-MONTELUKAST CHEWABLE 100'S A 14.14 0.1414 TAB 30 BOTT PMS PHARMASCIENCE COL COLLINS LTD B 481024 LEUKOTRIENE MODIFIERS 2024-04-01 2026-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A671V APO-MONTELUKAST CHEWABLE 4MG TAB (APO/COL) MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.59 0.12 TABLET 30 TAB APO APOTEX INC. COL COLLINS LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 6 RESPIRATORY TRACT AGENTS
42 A671V APO-MONTELUKAST CHEWABLE 4MG TAB (A MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.67 0.12 TAB 30 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A671W APO-MONTELUKAST CHEWABLE 5MG TAB (APO/COL) MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.86 0.13 TABLET 30 TAB APO APOTEX INC. COL COLLINS LTD B 481024 LEUKOTRIENE MODIFIERS 2022-04-01 2024-03-31 Oral 6 RESPIRATORY TRACT AGENTS
42 A671W APO-MONTELUKAST CHEWABLE 5MG TAB (APO) MONTELUKAST APO-MONTELUKAST CHEWABLE 30'S A 3.94 0.13 TAB 30 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 481024 LEUKOTRIENE MODIFIERS 2026-04-01 2028-03-31 ORAL 6 LEUKOTRIENE MODIFIERS
40 A6812 COMBIVIR 150MG | 300MG TAB (GSK/COL) LAMIVUDINE | ZIDOVUDINE LAMIVUDINE|ZIDOVUDINE COMBIVIR 60'S BL 135.02 2.25 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 08180892 ANTIRETROVIRALS MISCELLANEOUS 2022-04-01 2022-05-31 Delete from contract Oral 0 ANTI-INFECTIVE AGENTS 2022-04-19