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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 52217 APO-BACLOFEN 10MG TAB (APO/COL) BACLOFEN APO-BACLOFEN 100'S A 6.12 0.06 TABLET 180 TAB APO APOTEX INC. COL COLLINS LTD 122012 GABA DERIVED SKELETAL MUSCLE RELAXANTS 2022-04-01 2024-03-31 Oral 6 AUTONOMIC DRUGS
41 5221AB APO-BACLOFEN 10MG TAB (APO) BACLOFEN APO-BACLOFEN 100'S A 6.25 0.0625 TAB 180 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 122012 GABA DERIVED SKELETAL MUSCLE RELAXANTS 2024-04-01 2026-03-31 ORAL 6 GABA DERIVED SKELETAL MUSCLE RELAXANTS
41 5221AC BACLOFEN 10MG TAB (FSB) BACLOFEN BACLOFEN 10X10 A 5.46 0.0546 TAB 180 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 122012 GABA DERIVED SKELETAL MUSCLE RELAXANTS 2024-04-01 2026-03-31 ORAL 6 GABA DERIVED SKELETAL MUSCLE RELAXANTS
40 5221N PMS-BACLOFEN 10MG TAB (PMS/COL) BACLOFEN PMS-BACLOFEN 100'S A 7.48 0.07 TABLET 180 TAB PMS PHARMASCIENCE COL COLLINS LTD 122012 GABA DERIVED SKELETAL MUSCLE RELAXANTS 2022-04-01 2024-03-31 Oral 6 AUTONOMIC DRUGS