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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 26517 BETAMETHASONE 0.5MG TAB (LAF) BETAMETHASONE BETAMETHASONE 100'S A 61.16 0.6116 TAB 240 BOX LAF LABORATORIOS ALFA AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2024-04-01 2026-03-31 ORAL 6 ADRENALS
42 26517 BETAMETHASONE 0.5MG TAB (LAF) BETAMETHASONE BETAMETHASONE 100'S A 47.03 0.47 TAB 240 BLIS LAF LABORATORIOS ALFA AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS
40 26613 PMS-DEXAMETHASONE 0.5MG TAB (PMS/COL) DEXAMETHASONE PMS-DEXAMETHASONE 100'S A 8.43 0.08 TABLET 90 TAB PMS PHARMASCIENCE COL COLLINS LTD 6804 ADRENALS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
40 26614 APO-DEXAMETHASONE 0.5MG TAB (APO/COL) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 8.43 0.08 TABLET 90 TAB APO APOTEX INC. COL COLLINS LTD 6804 ADRENALS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
42 26614 APO-DEXAMETHASONE 0.5MG TAB (APO) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 8.43 0.08 TAB 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS
41 2661S APO-DEXAMETHASONE 0.5MG TAB (APO) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 8.59 0.0859 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 6804 ADRENALS 2024-04-01 2026-03-31 ORAL 6 ADRENALS
40 2662E SONEXA 0.1% EYE DR (ARP/AHI) DEXAMETHASONE DEXAMETHASONE SONEXA 5ML B 4.57 4.57 EYE DROP 0 BOTT ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 5208 EENT ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
42 2662E SONEXA 0.1% EYE DR (ARP) DEXAMETHAS DEXAMETHASONE SONEXA 5ML B 4.05 4.05 BOTT 1 BOTT ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 5208 EENT ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 OPHTHALMIC 6 EENT ANTI-INFLAMMATORY AGENTS
41 2662F MONODEXA 0.1% EYE DR (SHC) DEXAMETHASONE (B) DEXAMETHASONE MONODEXA 5ML B 4.08 4.0775 BOTT 1 BOTT SHC SION HEALTHCARE PSB PHARMACEUTICAL SOLUTIONS BARBA 5208 EENT ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 6 EENT ANTI-INFLAMMATORY AGENTS
42 2662F MONODEXA 0.1% EYE DR (SHC) DEXAMETHASONE DEXAMETHASONE MONODEXA 5ML B 4.08 4.08 BOTT 1 BOTT SHC SION HEALTHCARE PSB PHARMACEUTICAL SOLUTIONS BARBA 5208 EENT ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 OPHTHALMIC 6 EENT ANTI-INFLAMMATORY AGENTS
40 26636 APO-DEXAMETHASONE 4MG TAB (APO/COL) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 21.20 0.21 TABLET 90 TAB APO APOTEX INC. COL COLLINS LTD 6804 ADRENALS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
42 26636 APO-DEXAMETHASONE 4MG TAB (APO) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 21.20 0.21 TAB 90 BOTT APO APOTEX INC. COL AVENTA BARBADOS 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS
42 26637 PMS-DEXAMETHASONE 4MG TAB (PMS) DEXAMETHASONE PMS-DEXAMETHASONE 100'S A 16.31 0.16 TAB 90 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS
41 2663B DARDEX 4MG TAB (MBL) DEXAMETHASONE DEXAMETHASONE DARDEX 30'S A 6.33 0.2111 TAB 90 BOX MBL MEDICAMEN BIOTECH LTD AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2024-04-01 2026-03-31 ORAL 6 ADRENALS
41 2663C APO-DEXAMETHASONE 4MG TAB (APO) DEXAMETHASONE APO-DEXAMETHASONE 100'S A 21.64 0.2164 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 6804 ADRENALS 2024-04-01 2026-03-31 ORAL 6 ADRENALS
40 26719 FLUDROCORTISONE 0.1MG TAB (SLS/AHI) FLUDROCORTISONE FLUDROCORTISONE 200'S A 162.83 0.81 TABLET 60 TAB SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 2671A FLUDROCORTISONE 0.1MG TAB (SLS) FLUDROCORTISONE FLUDROCORTISONE 200'S A 167.45 0.8372 TAB 60 BOX SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2024-04-01 2026-03-31 ORAL 6 ADRENALS
42 2671A FLUDROCORTISONE 0.1MG TAB (SLS) FLUDROCORTISONE FLUDROCORTISONE 200'S A 167.97 0.84 TAB 60 BLIS SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS
40 26818 HYDROCORTISONE 10MG TAB (SLS/AHI) HYDROCORTISONE HYDROCORTISONE 200'S A 150.51 0.75 TABLET 120 TAB SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
42 26818 HYDROCORTISONE 10MG TAB (SLS) HYDROCORTISONE HYDROCORTISONE 200'S A 58.61 0.29 TAB 120 BLIS SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2026-04-01 2028-03-31 ORAL 6 ADRENALS