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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 4211BE BETAZOLE 0.25% | 1% CR (LDP/AHI) BECLOMETHASONE | CLOTRIMAZOLE BECLOMETHASONE|CLOTRIMAZOLE BETAZOLE 10G A 3.18 3.18 CREAM 2 TUBE LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 8410 ANTI-INFECTIVES & ANTI-INFLAMMATORIES 2022-04-01 2024-03-31 TOPICAL 6 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5231BU CLOTRIMAZOLE 1% CR (HEA/RXP) CLOTRIMAZOLE CLOTRIMAZOLE 15G A 1.44 1.44 CREAM 2 TUBE HEA HEALTH 2000 INC RXP RX PRO INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231CE CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.3453 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231CE CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.35 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL 2026-02-11
42 5231CH CANDID 1% CREAM (GLP) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 20G A 1.09 1.09 TUBE 2 TUBE GLP GLENMARK PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231ED CANESTEN 1% CR (BSP/COL) CLOTRIMAZOLE CLOTRIMAZOLE CANESTEN 15G C 8.97 8.97 CREAM 0 TUBE BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231ED CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 8.35 8.3453 TUBE 2 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231ED CANESTEN 1% CR (BSP) CLOTRIMAZOLE (C) CLOTRIMAZOLE CANESTEN 15G C 6.69 6.69 TUBE 2 TUBE BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231EF CANESTEN 1% CR (BSP/AHI) CLOTRIMAZOLE CLOTRIMAZOLE CANESTEN 20G C 8.15 8.15 CREAM 0 TUBE BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2022-09-30 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-29
40 5231EK CLOTRIMAZOLE 1% CR (HEA/ATB) CLOTRIMAZOLE CLOTRIMAZOLE 15G A 1.44 1.44 CREAM 2 HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-07-12 la Topical 0 ANTIFUNGALS TOPICAL
40 5231EK CLOTRIMAZOLE 1% CR (HEA/ATB) CLOTRIMAZOLE CLOTRIMAZOLE 15G A 1.44 1.44 CREAM HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-12-07 2024-03-31 Change Local Agent Topical 0 ANTIFUNGALS TOPICAL 2022-11-25
41 5231EK CLOTRIMAZOLE 1% CR (HEA) CLOTRIMAZOLE CLOTRIMAZOLE 15G A 1.55 1.5494 TUBE 2 BOX HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 Topical 0 ANTIFUNGALS TOPICAL
42 5231FY CANDID 1% CR (GLP) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 20G A 1.09 1.09 TUBE 2 TUBE GLP GLENMARK PHARMACEUTICALS LTD CWS CAPSULE WHOLESALE 081404 ALLYAMINES 2026-04-01 TOPICAL 0 ALLYAMINES
41 5231ZH CLODERM 1% CR (CAR) CLOTRIMAZOLE (C) CLOTRIMAZOLE CLODERM 15G C 3.07 3.0717 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231ZH CLODERM 1% CR (CAR) CLOTRIMAZOLE (C) CLOTRIMAZOLE CLODERM 15G C 3.18 3.18 TUBE 2 TUBE CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5232AZ CANDID 1% EAR DR (GLP/ALI) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 15ML A 6.80 6.80 EAR DROP 1 BOTT GLP GLENMARK PHARMACEUTICALS LTD ALI ALL HEALTH INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2022-03-22 Delete from contract OTIC 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 5232BN CANDID 1% EAR DR (GLP/ATB) CLOTRIMAZOLE CLOTRIMAZOLE CANDID 15ML A 6.80 6.80 EAR DROP 1 BOTT GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 Change Local Agent OTIC 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 5232BP CANDID MOUTH PAINT 1% SOLN (GLP/ATB) CLOTRIMA CLOTRIMAZOLE CANDID MOUTH PAINT 20ML A 6.80 6.80 SOLUTION 2 BOTT GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 Change Local Agent TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
41 5232BT CLOTRIMAZOLE 1% SOLN (CHC) CLOTRIMAZOLE CLOTRIMAZOLE 30ML A 2.12 2.1203 BOTT 2 BOTT CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5232ZA CANDID MOUTH PAINT 1% SOLN (GLP/ALI) CLOTRIMA CLOTRIMAZOLE CANDID MOUTH PAINT 20ML A 6.80 6.80 SOLUTION 2 BOTT GLP GLENMARK PHARMACEUTICALS LTD ALI ALL HEALTH INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2022-03-22 Delete from contract TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22