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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 0012FY FEXOSTAL 180MG TAB (STL) FEXOFENADINE FEXOFENADINE FEXOSTAL 10X10 C 10.14 0.10 TAB 0 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012FZ ALFREE 10MG TAB (STL) CETIRIZINE CETIRIZINE ALFREE 10X10 A 1.41 0.01 TAB 14 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012GA DESLORASTAL 5MG TAB (STL) DESLORATADINE DESLORATADINE DESLORASTAL 10X10 C 4.05 0.04 TAB 0 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012GB LORASTAL 10MG TAB (STL) LORATADINE LORATADINE LORASTAL 10X10 A 2.04 0.02 TAB 14 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012GR FEEGRA 120MG SR TAB (JLP) FEXOFENADINE FEXOFENADINE FEEGRA 10X10 C 27.18 0.27 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
40 0012V CETIRIZINE 10MG TAB (HEA/RXP) CETIRIZINE CETIRIZINE 1X10 A 0.95 0.10 TABLET 14 TAB HEA HEALTH 2000 INC RXP RX PRO INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012VB CETIRIZINE 10MG TAB (HEA/ATB) CETIRIZINE CETIRIZINE 1X10 A 0.95 0.095 TABLET IMMED HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-07 2024-03-31 Change Local Agent oral 0 SECOND GENERATION ANTIHISTAMINES 2022-11-25
40 0012Y ZYRTEC 10MG TAB (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 20'S C 20.69 1.03 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0012Y ZYRTEC 10MG TAB (GSK) CETIRIZINE (C) CETIRIZINE ZYRTEC 20'S C 22.75 1.1376 TAB 14 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012Y ZYRTEC 10MG TAB (GSK) CETIRIZINE CETIRIZINE ZYRTEC 20'S C 25.23 1.26 TAB 14 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 Price Change ORAL 0 SECOND GENERATION ANTIHISTAMINES 2026-02-16
40 0013AF ZYRTEC 10MG/ML DROPS (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 10ML C 11.85 11.85 DROPS 0 BOTT GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013AZ LEVOCETIRIZINE 2.5MG/ML SYR (CIR/AHI) LEVOCETIRIZINE LEVOCETIRIZINE 60ML C 5.71 0.10 SYRUP 0 ML CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013BH DPH ELIXIR 2.5MG/ML SYR (FED/RXP) DIPHENHYDRA DIPHENHYDRAMINE DPH ELIXIR 120ML A 4.08 0.03 SYRUP 120 ML FED FEDERATED PHARMACEUTICAL CO. LT RXP RX PRO INC 0404 FIRST GENERATION ANTIHISTAMINES 2022-04-01 2022-05-11 Delete from contract Oral 6 ANTIHISTAMINICS 2022-05-11
40 0013BK AERIUS 0.5MG/ML SYR (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 60ML C 11.74 0.20 SYRUP 0 ML MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0013BK AERIUS 0.5MG/ML SYR (MSD) DESLORATADINE (C) DESLORATADINE AERIUS 60ML C 11.88 0.198 ML 60 BOTT MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0404 FIRST GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 FIRST GENERATION ANTIHISTAMINES
42 0013BK AERIUS 0.5MG/ML SYR (MSD) DESLORATADINE DESLORATADINE AERIUS 60ML C 11.88 0.20 ML 60 BOTT MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0404 FIRST GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 FIRST GENERATION ANTIHISTAMINES
40 0013BL DPH ELIXIR 2.5MG/ML SYR (FED/ATB) DIPHENHYDRA DIPHENHYDRAMINE DPH ELIXIR 120ML A 4.08 0.03 SYRUP 120 ML FED FEDERATED PHARMACEUTICAL CO. LT ATB ANSA TRADING BARBADOS LTD 0404 FIRST GENERATION ANTIHISTAMINES 2022-05-11 2024-03-31 Change Local Agent Oral 6 ANTIHISTAMINICS 2022-05-11
40 0013BP CLARITINE 10MG TAB (BSP/AHI) LORATADINE (C) LORATADINE CLARITINE 30'S C 9.51 0.317 TABLET CONTR BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 408 SECOND GENERATION ANTIHISTAMINES 2023-02-21 2023-04-07 Add to Contract as Cat C Oral SECOND GENERATION ANTIHISTAMINES 2023-02-24
42 0013BT CETIRIZINE 1MG/ML SOLN (HEA) CETIRIZINE CETIRIZINE 60ML A 2.83 0.05 ML 60 BOTT HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 Price Change ORAL 0 SECOND GENERATION ANTIHISTAMINES 2025-10-31
42 0013BU LORATADINE 1MG/ML SOLN (HEA) LORATADINE LORATADINE 100ML A 3.13 0.03 ML 60 BOTT HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 0404 FIRST GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 FIRST GENERATION ANTIHISTAMINES