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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 66613 TAMBOCOR 100MG TAB (PMA/AHI) FLECAINIDE FLECAINIDE TAMBOCOR 25'S C 25.82 1.03 TABLET 0 TAB PMA MORE PHARMA CORPORATION AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 66615 FLECAINIDE 100MG TAB (ROL) (B) FLECAINIDE FLECAINIDE 60'S B 85.41 1.4235 TAB 90 BOX ROL ROXANE LABORATORIES INC. AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
40 66616 APO-FLECAINIDE 100MG TAB (APO/COL) FLECAINIDE APO-FLECAINIDE 100'S B 44.85 0.45 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 240404 ANTIARRHYTHMIC AGENTS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 6661D FLECAINIDE 100MG TAB (LDP) (B) FLECAINIDE FLECAINIDE 20'S B 26.94 1.3469 TAB 90 BOTT LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS
41 6661F APO-FLECAINIDE 100MG TAB (APO) (B) FLECAINIDE APO-FLECAINIDE 100'S B 45.75 0.4575 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 240404 ANTIARRHYTHMIC AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIARRHYTHMIC AGENTS