Displaying 1 - 11 of 11
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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 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 10'S C 9.51 0.95 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADIN (C) FEXOFENADINE ALLEGRA 10'S C 16.31 1.631 TABLET IMMED SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 10'S C 10.19 1.02 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADIN (C) FEXOFENADINE ALLEGRA 10'S C 24.19 2.419 TABLET IMMED SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
41 0012FR AXOFEN 120MG TAB (ARP) FEXOFENADINE (C) FEXOFENADINE AXOFEN 30'S C 23.27 0.7756 TAB 0 BOX ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012FY FEXOSTAL 180MG TAB (STL) FEXOFENADINE FEXOFENADINE FEXOSTAL 10X10 C 10.14 0.10 TAB 0 BLIS STL STALLION LABORATORIES SBI MASSY DISTRIBUTION (BDOS) LTD 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012GR FEEGRA 120MG SR TAB (JLP) FEXOFENADINE FEXOFENADINE FEEGRA 10X10 C 27.18 0.27 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENADINE FEXOFENADINE ALLEGRA 150ML C 13.59 0.09 SUSPENSION 0 ML SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013G ALLEGRA 6MG/ML SUSP (SFA/COL) FEXOFENAD (C) FEXOFENADINE ALLEGRA 150ML C 29.36 0.1957 SUSPENSION SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09
40 3791J ALLEGRA -D 120MG F/60MG P TAB (SFA/COL) FEXOF FEXOFENADINE|PSEUDOEPHEDRINE ALLEGRA -D 10'S C 11.15 1.12 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 3791J ALLEGRA -D 120MG F/60MG P TAB (SFA/COL) FEXOF (C) FEXOFENADINE|PSEUDOEPHEDRINE ALLEGRA -D 10'S C 14.54 1.454 TABLET IMMED SFA SANOFI AVENTIS COL COLLINS LTD 408 SECOND GENERATION ANTIHISTAMINES 2022-12-10 2024-03-31 Price Change Oral 0 SECOND GENERATION ANTIHISTAMINES 2022-12-09