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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 1642X HALOPERIDOL 5MG/ML INJ (MON/PHA) HALOPERIDOL HALOPERIDOL 10X1ML B 6.20 0.62 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 28160808 BUTYROPHENES 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
42 1642X HALOPERIDOL 5MG/ML INJ (MON) HALOPERIDOL HALOPERIDOL 10X1ML B 6.47 0.65 AMPG 0 BOX MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 28160808 BUTYROPHENES 2026-04-01 IV 6 BUTYROPHENES
40 16441 HALOXEM 5MG TAB (REM/SBI) HALOPERIDOL HALOPERIDOL HALOXEM 1000'S A 73.07 0.07 TABLET 180 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 28160808 BUTYROPHENES 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 16441 HALOXEN 5MG TAB (REM) HALOPERIDOL HALOPERIDOL HALOXEN 1000'S A 71.03 0.071 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 28160808 BUTYROPHENES 2024-04-01 2026-03-31 ORAL 6 BUTYROPHENES
42 16441 HALOXEN 5MG TAB (REM) HALOPERIDOL HALOPERIDOL HALOXEN 1000'S A 71.76 0.07 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 28160808 BUTYROPHENES 2026-04-01 ORAL 6 BUTYROPHENES
40 1644T HALDOL 5MG TAB (JAC/STO) HALOPERIDOL HALOPERIDOL HALDOL 20'S C 32.27 1.61 TABLET 0 TAB JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 28160808 BUTYROPHENES 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 1644T HALDOL 5MG TAB (JAC) HALOPERIDOL (C) HALOPERIDOL HALDOL 20'S C 32.27 1.6133 TAB 180 BOX JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 28160808 BUTYROPHENES 2024-04-01 2026-03-31 ORAL 6 BUTYROPHENES
42 16525 AAP-HYDROXYZINE 10MG CAP (APO) HYDROXYZINE AAP-HYDROXYZINE 100'S C 22.05 0.22 CAP 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 0 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
42 1652B HYDROXYZINE 10MG TAB (IPC) HYDROXYZINE HYDROXYZINE 84'S A 10.93 0.13 TAB 90 BLIS IPC IPCA Laboratories Ltd. CWS CAPSULE WHOLESALE 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
41 1652C HYDROXYZINE 10MG TAB (WAT) HYDROXYZINE HYDROXYZINE 100'S A 13.35 0.1335 TAB 90 BOX WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
40 1652E AAP-HYDROXYZINE 10MG TAB (APO/COL) HYDROXYZIN HYDROXYZINE AAP-HYDROXYZINE 100'S A 15.28 0.15 TABLET 90 TAB APO APOTEX INC. COL COLLINS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 1652G HYDROXYZINE 10MG TAB (CAM) HYDROXYZINE HYDROXYZINE 84'S A 9.7 0.1155 TAB 90 BOTT CAM MORNINGSIDE PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
42 1652K HYDROZYL 10MG TAB (JLP) HYDROXYZINE HYDROXYZINE HYDROZYL 150'S A 10.87 0.07 TAB 90 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
42 16533 AAP-HYDROXYZINE 25MG CAP (APO) HYDROXYZINE AAP-HYDROXYZINE 100'S C 25.55 0.26 CAP 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 0 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
41 16539 HYDROXYZINE 25MG TAB (WAT) HYDROXYZINE HYDROXYZINE 100'S A 17.81 0.178 TAB 90 BOX WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
41 1653D AAP-HYDROXYZINE 25MG TAB (APO) HYDROXYZINE AAP-HYDROXYZINE 25MG 100'S A 17.34 0.1734 BOTT 90 TAB APO APOTEX INC COL COLLINS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS ORAL 6 CENTRAL NERVOUS SYSTEM DRUGS
40 1653D AAP-HYDROXYZINE 25MG TAB (APO/COL) HYDROXYZINE AAP-HYDROXYZINE 100'S A 16.99 0.17 TABLET 90 TAB APO APOTEX INC. COL COLLINS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 1653F AAP-HYDROXYZINE 25MG TAB (APO) HYDROXYZINE AAP-HYDROXYZINE 100'S A 17.34 0.1734 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
42 1653H HYDROXYZINE 25MG TAB (IPC) HYDROXYZINE HYDROXYZINE 28'S A 1.90 0.07 TAB 90 BLIS IPC IPCA Laboratories Ltd. CWS CAPSULE WHOLESALE 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
42 1653J HYDROZYL 25MG TAB (JLP) HYDROXYZINE HYDROXYZINE HYDROZYL 10X15 A 13.59 0.09 TAB 90 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2026-04-01 ORAL 6 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL