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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 0131AE AZITHROMYCIN MK 40MG/ML SUSP (BON/COL) AZITHROMYCIN AZITHROMYCIN MK 15ML A 5.30 0.35 SUSPENSION 30 ML BON CORPORACION BONIMA COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
42 0131B AZITHRO EZE 40MG/ML SUSP (INF) AZITHROMYCIN AZITHROMYCIN AZITHRO EZE 15ML A 4.59 0.31 ML 30 BOTT INF INFOCUS REMEDIES PVT RXP RX PRO INC 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0131BE SKAZI 40MG/ML SUSP (SKH/RXP) AZITHROMYCIN AZITHROMYCIN SKAZI 15ML A 4.89 0.33 SUSPENSION 30 ML SKH S. KANT HEALTHCARE LTD RXP RX PRO INC 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131CW AZITHROMYCIN 40MG/ML SUSP (KWA/ATB) AZITHROMYCIN AZITHROMYCIN 15ML A 4.76 0.32 SUSPENSION 30 ML KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 08121292 OTHER MACROLIDES 2022-04-01 2022-09-30 Oral 0 ANTI-INFECTIVE AGENTS 2022-03-30
40 0131CX BINOZYT 40MG/ML SUSP (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 30ML C 20.12 0.67 SUSPENSION 0 ML BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM (C) AZITHROMYCIN BINOZYT 30ML C 29.11 0.9704 ML 30 BOTT BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM AZITHROMYCIN BINOZYT 30ML C 29.11 0.97 ML 30 BOTT BCH SANDOZ COL AVENTA BARBADOS B 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
41 0131DN AZICURE 40MG/ML SUSP (MBL) AZITHROM AZITHROMYCIN AZICURE 30ML A 9.24 0.3081 ML 30 BOTT MBL MEDICAMEN BIOTECH LTD AHI ARMSTRONG HEALTHCARE INC 08121204 ERYTHROMYCINS 2024-04-01 2026-03-31 ORAL 0 ERYTHROMYCINS
40 0131DT SKAZI 40MG/ML SUSP (SKH) AZITHROMYCIN SKAZI 40MG /ML SUSP 15ML A $4.89 SUSPENSION 30 SKH S KANT HEALTHCARE ATB ANSA TRADING BARBADOS LIMITED 08121292 0 0000-00-00
41 0131DT SKAZI 40MG/ML SUSP (SKH) AZITHROMYCIN AZITHROMYCIN SKAZI 15ML A 4.95 0.3298 ML 30 BOX SKH S. KANT HEALTHCARE LTD ATB ANSA TRADING BARBADOS LTD B 08121292 OTHER MACROLIDES 2024-06-05 2026-03-31 ORAL 0 OTHER MACROLIDES 2024-06-05
40 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 15ML C 29.66 1.98 SUSPENSION 0 ML PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHRO (C) AZITHROMYCIN ZITHROMAX 15ML C 29.96 1.9971 ML 30 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHR AZITHROMYCIN ZITHROMAX 15ML C 29.96 2.00 ML 30 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD B 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 3'S C 53.01 17.67 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY (C) AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.8413 TAB 7 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.84 TAB 10 BLIS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0141DA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 3'S C 8.64 2.88 TABLET 0 TAB BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0141DA BINOZYT 500MG TAB (BCH) AZITHROMYCIN (C) AZITHROMYCIN BINOZYT 3'S C 24.49 8.164 TAB 7 BOX BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0141DA BINOZYT 500MG TAB (BCH) AZITHROMYCIN AZITHROMYCIN BINOZYT 3'S C 27.84 9.28 TAB 10 BLIS BCH SANDOZ COL AVENTA BARBADOS 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0141GA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 12'S C 31.48 2.62 TABLET 0 TAB BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS