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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 2841FX METFORMIN 500MG XR TAB (BEX) METFORMIN XR METFORMIN 10X10 A 7.48 0.0748 TABXR 120 BOX BEX BEXIMCO PHARMACEUTICALS LTD RXP RX PRO INC B 682004 BIGUANIDES 2024-04-01 2026-03-31 ORAL 6 BIGUANIDES
41 2841GC LAFINE 500MG XR TAB (LDP) METFORMIN XR METFORMIN XR LAFINE 500'S A 34.88 0.0698 TABXR 120 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 682004 BIGUANIDES 2024-04-01 2024-06-06 ORAL 6 BIGUANIDES 2024-04-25
41 2841GM METFOR-EZE 500MG ER TAB (INF) METFORMIN XR METFORMIN XR METFOR-EZE 100'S A 7.48 0.0748 TABER 120 BOX INF INFOCUS REMEDIES PVT RXP RX PRO INC B 682004 BIGUANIDES 2024-04-24 2026-03-31 ORAL 6 BIGUANIDES 2024-04-24
42 2841GM METFOR-EZE 500MG XR TAB (INF) METFORMIN XR METFORMIN XR METFOR-EZE 100'S A 7.48 0.07 TAB 120 BLIS INF INFOCUS REMEDIES PVT RXP RX PRO INC B 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES
41 2841GN LAFINE 500MG XR TAB (LDP) METFORMIN XR METFORMIN XR LAFINE 100'S A 6.99 0.0699 TABXR 120 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC B 682004 BIGUANIDES 2024-04-25 2026-03-31 ORAL 6 BIGUANIDES 2024-04-25
42 2841HD METFORMIN 500MG XR TAB (HEA) METFORMIN XR METFORMIN 10X10 A 7.94 0.08 TAB 120 BLIS HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC B 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES 2025-10-31
42 2841HN METFORMIN 500MG XR TAB (HEA) METFORMIN XR METFORMIN 10X10 A 7.94 0.08 TAB 120 BLIS HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES 2026-01-26
42 2841HP METFORMIN 500MG ER TAB (HEA) METFORMIN XR METFORMIN 10X10 A 7.94 0.08 TAB 120 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES 2026-02-27
40 2841T GLUCOPHAGE XR 500MG TAB (MEK/COL) METFORMIN X METFORMIN XR GLUCOPHAGE XR 30'S C 21.75 0.73 TABLET 0 TAB MEK MERCK SERONO COL COLLINS LTD B 682004 BIGUANIDES 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 2841T GLUCOPHAGE 500MG XR TAB (MEK) METFORMIN XR (C) METFORMIN XR GLUCOPHAGE 30'S C 21.75 0.7249 TABXR 120 BOX MEK MERCK SERONO COL COLLINS LTD B 682004 BIGUANIDES 2024-04-01 2026-03-31 ORAL 6 BIGUANIDES
42 2841T GLUCOPHAGE 500MG XR TAB (MEK) METFORMIN XR METFORMIN XR GLUCOPHAGE 30'S C 22.18 0.74 TABXR 120 BLIS MEK MERCK SERONO COL AVENTA BARBADOS B 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES
40 28422 GLUCOPHAGE 850MG TAB (MEK/COL) METFORMIN METFORMIN GLUCOPHAGE 100'S C 16.36 0.16 TABLET 60 TAB MEK MERCK SERONO COL COLLINS LTD B 682004 BIGUANIDES 2022-08-25 2024-03-31 Add to Contract as Cat C Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-08-25
40 2842AC GLUCOPHAGE XR 750MG TAB (MEK/COL) METFORMIN METFORMIN GLUCOPHAGE XR 30'S C 27.18 0.91 TABLET 0 TAB MEK MERCK SERONO COL COLLINS LTD 682004 BIGUANIDES 2022-08-25 2024-03-31 Add to Contract as Cat C Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES 2022-08-25
41 2842AC GLUCOPHAGE 750MG XR TAB (MEK) METFORMIN XR (C) METFORMIN XR GLUCOPHAGE 30'S C 27.18 0.9061 TABXR 0 BOX MEK MERCK SERONO COL COLLINS LTD 682004 BIGUANIDES 2024-04-01 2026-03-31 ORAL 0 BIGUANIDES
42 2842AC GLUCOPHAGE 750MG XR TAB (MEK) METFORMIN XR METFORMIN XR GLUCOPHAGE 30'S C 33.16 1.11 TABXR 0 BLIS MEK MERCK SERONO COL AVENTA BARBADOS 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 0 BIGUANIDES
40 2842C GLYFORMIN 850MG TAB (REM/SBI) METFORMIN METFORMIN GLYFORMIN 500'S A 28.95 0.06 TABLET 90 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 682004 BIGUANIDES 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 2842C GLYFORMIN 850MG TAB (REM) METFORMIN METFORMIN GLYFORMIN 500'S A 50.97 0.1019 TAB 90 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 682004 BIGUANIDES 2024-04-01 2026-03-31 ORAL 6 BIGUANIDES
42 2842C GLYFORMIN 850MG TAB (REM) METFORMIN METFORMIN GLYFORMIN 500'S A 80.57 0.16 TAB 90 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 682004 BIGUANIDES 2026-04-01 2028-03-31 ORAL 6 BIGUANIDES
40 28432 GLUCOPHAGE XR 1G TAB (MEK/COL) METFORMIN XR METFORMIN XR GLUCOPHAGE XR 30'S C 32.67 1.09 TABLET 0 TAB MEK MERCK SERONO COL COLLINS LTD B 682004 BIGUANIDES 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 28432 GLUCOPHAGE 1G XR TAB (MEK) METFORMIN XR (C) METFORMIN XR GLUCOPHAGE 30'S C 32.67 1.0891 TABXR 0 BOX MEK MERCK SERONO COL COLLINS LTD B 682004 BIGUANIDES 2024-04-01 2026-03-31 ORAL 6 BIGUANIDES