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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 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
41 0012Y
41 0012Y ZYRTEC 10MG TAB (GSK/COL) CETIRIZINE CETIRIZINE ZYRTEC 20'S C 22.75 1.1376 TAB 14 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
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
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
41 0013BK
41 0013BK AERIUS 0.5MG/ML SYR (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 60ML C 11.88 0.198 SYR 60 ML MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0404 FIRST GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
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
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
41 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI CHLORPHENIRAMINE HISTAL 2 LITRES A 46.16 0.0231 SYR 100 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 0404 FIRST GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
40 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI CHLORPHENIRAMINE HISTAL 2 LITRES A 34.79 0.02 SYRUP 100 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 0404 FIRST GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 150ML C 13.59 0.09 SUSPENSION 0 ML SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENAD (C) FEXOFENADINE ALLEGRA 150ML C 29.36 0.1957 SUSPENSION SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 0013K CETIRIZINE 1MG/ML SYR (HEA/RXP) CETIRIZINE CETIRIZINE 60ML A 2.69 0.04 SYRUP 60 ML HEA HEALTH 2000 INC RXP RX PRO INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0013KA CETIRIZINE 1MG/ML SYR (HEA/ATB) CETIRIZINE CETIRIZINE 60ML A 2.91 0.0485 SYR 60 ML HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 0408 SECOND GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
40 0013KA CETIRIZINE 1MG/ML SYR (HEA/ATB) CETIRIZINE CETIRIZINE 60ML A 2.69 0.0448 SYRUP 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 0013P LORATADINE 1MG/ML SYRUP (HEA/RXP) LORATADINE LORATADINE 100ML A 3.13 0.03 SYRUP 120 ML HEA HEALTH 2000 INC RXP RX PRO INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS