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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 42013 PRETERAX 0.625MG | 2.5MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42013 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
42 42013 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
40 42014 PRETERAX 0.625MG | 2.5MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42014 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
42 42014 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
40 42024 PRETERAX 2.5MG | 10MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42024 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
42 42024 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
41 42025 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
42 42025 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
42 42026 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
40 42027 PRETERAX 2.5MG | 10MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42027 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
42 42027 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.24 TAB 0 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS 243204 ACE INHIBITORS 2026-04-01 ORAL 0 ACE INHIBITORS
40 42028 PRETERAX 1.5MG | 5MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42028 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42029 PRETERAX 1.5MG | 5MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
40 66511 INALIX SR 1.5MG TAB (HEA/RXP) INDAPAMIDE INDAPAMIDE INALIX SR 3X10 C 2.91 0.10 TABLET 0 TAB HEA HEALTH 2000 INC RXP RX PRO INC B 402824 THIAZIDE LIKE DIURETICS 2022-04-01 2024-03-31 Oral 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
40 6651A NATRILIX SR 1.5MG TAB (SER/STO) INDAPAMIDE INDAPAMIDE NATRILIX SR 30'S A 5.98 0.20 TABLET 30 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 402824 THIAZIDE LIKE DIURETICS 2022-04-01 2024-03-31 Oral 6 ELECTROLYTIC, CALORIC, AND WATER BALANCE