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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 55011 AROMASIN 25MG TAB (PFI/STO) EXEMESTANE EXEMESTANE AROMASIN 30'S C 259.76 8.66 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
41 55011 AROMASIN 25MG TAB (PFI) EXEMESTANE (C) EXEMESTANE AROMASIN 30'S C 259.76 8.6588 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
41 55015 EXEMESTANE 25MG TAB (REM) (BQ) EXEMESTANE EXEMESTANE 30'S BQ 11.53 0.3842 TAB 30 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
40 55018 EXETAS 25MG TAB (INP/AHI) EXEMESTANE EXEMESTANE EXETAS 3X10 BQ 223.12 7.44 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS