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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 19322 VIAGRA 50MG TAB (PFI/STO) SILDENAFIL SILDENAFIL VIAGRA 4'S C 56.62 14.16 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19322 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 4'S C 58.58 14.645 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19323 VIAGRA 50MG TAB (PFI/SBI) SILDENAFIL SILDENAFIL VIAGRA 1'S C 16.04 16.04 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19323 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 1'S C 16.58 16.5818 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19324 VIAGRA 50MG TAB (PFI/SBI) SILDENAFIL SILDENAFIL VIAGRA 4'S C 56.62 14.16 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19324 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 4'S C 58.58 14.645 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 1932AK INTAGRA 50MG TAB (INP/AHI) SILDENAFIL SILDENAFIL INTAGRA 4'S BQ 1.20 0.30 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 1932AK INTAGRA 50MG TAB (INP) SILDENAFIL (BQ) SILDENAFIL INTAGRA 4'S BQ 0.95 0.2378 TAB 30 BOX INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 1932AR SILDENAFIL 50MG TAB (MCP/AHI) SILDENAFIL SILDENAFIL 4'S BQ 1.25 0.31 TABLET 0 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 1932AR SILDENAFIL 50MG TAB (MCP) SILDENAFIL SILDENAFIL 4'S BQ 0.79 0.20 TAB 30 BLIS MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2026-04-01 ORAL 0 PHOSPHODIESTERASE INHIBITORS
41 1932AU ZENEGRA 50MG TAB (RYV) SILDENAFIL (BQ) SILDENAFIL ZENEGRA 4'S BQ 2.09 0.5233 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2024-06-18 ORAL 6 PHOSPHODIESTERASE INHIBITORS 2024-06-18
41 1932AU ZENEGRA 50MG TAB (RYV) SILDENAFIL (BQ) SILDENAFIL ZENEGRA 4'S BQ 3.18 0.795 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-06-19 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS 2024-06-19
42 1932BB PENAGRA 50MG TAB (ZYD) SILDENAFIL SILDENAFIL PENAGRA 4'S BQ 1.28 0.32 TAB 30 BLIS ZYD ZYDUS AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2026-04-01 ORAL 0 PHOSPHODIESTERASE INHIBITORS
41 1932V XCITE 50MG TAB (GPC) SILDENAFIL (BQ) SILDENAFIL XCITE 4'S BQ 1.01 0.2514 TAB 30 BOTT GPC NEW GUYANA PHARMACEUTICAL CORP. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19412 URS-11 STRP (TED/COL) DIAGNOSTIC URINE DIAGNOSTIC URINE URS-11 100'S B 28.54 28.54 STRIP 0 BOTT TED TECO DIAGNOSTICS COL COLLINS LTD 3688 URINE CONTENTS 2022-04-01 2024-03-31 0 DIAGNOSTIC AGENTS
41 19412 URS-11 STRP (TED) DIAGNOSTIC URINE (B) DIAGNOSTIC URINE URS-11 100'S B 40.77 40.7749 BOTT 0 BOTT TED TECO DIAGNOSTICS COL COLLINS LTD 3688 URINE CONTENTS 2024-04-01 2026-03-31 0 URINE CONTENTS
42 19412 URS-11 STRP (TED) DIAGNOSTIC URINE DIAGNOSTIC URINE URS-11 100'S C 40.77 40.77 BOTT 0 BOTT TED TECO DIAGNOSTICS COL AVENTA BARBADOS 3688 URINE CONTENTS 2026-04-01 0 URINE CONTENTS
40 19415 MEDI-TEST COMBI 10 STRP (SCN/PHA) DIAGNOSTIC URINE DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 15.22 15.22 STRIP 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2022-04-01 2022-07-18 0 DIAGNOSTIC AGENTS
40 19415 MEDI-TEST COMBI 10 STRP (SCN/PHA) DIAGNOSTIC URINE DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 20.44 20.44 STRIP 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2022-07-19 2024-03-31 Price Change 0 DIAGNOSTIC AGENTS 2022-07-18
41 19415 MEDI-TEST COMBI 10 STRP (SCN) DIAGNOSTIC URINE (B) DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 25.1 25.1 BOTT 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2024-04-01 2026-03-31 0 URINE CONTENTS 2023-10-05