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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 2831FJ DAONIL 5MG TAB (SFA/COL) GLIBENCLAMIDE GLIBENCLAMIDE DAONIL 100'S A 10.87 0.11 TABLET 120 TAB SFA SANOFI AVENTIS COL COLLINS LTD B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 2831GT GLITISOL 5MG TAB (REM) GLIBENCLAMIDE GLIBENCLAMIDE GLITISOL 40'S A 2.15 0.0537 TAB 120 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD B 682020 SULPHONYLUREAS 2024-04-01 2026-03-31 ORAL 6 SULPHONYLUREAS
42 2831HD GLIFORD 5MG TAB (JLP) GLIBENCLAMIDE GLIBENCLAMIDE GLIFORD 200'S A 10.33 0.05 TAB 120 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 682020 SULPHONYLUREAS 2026-04-01 ORAL 6 SULPHONYLUREAS