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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 5231AY NIZORAL 2% CR (JAC/STO) KETOCONAZOLE KETOCONAZOLE NIZORAL 40G C 22.26 22.26 CREAM 0 TUBE JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231AY NIZORAL 2% CR (JAC) KETOCONAZOLE (C) KETOCONAZOLE NIZORAL 40G C 22.26 22.2631 TUBE 2 BOX JAC JANSSEN-CILAG STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231BA KETOZAL 2% CR (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 15G C 3.26 3.26 CREAM 0 TUBE CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231BA KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 15G C 3.48 3.4795 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231BA KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 15G C 3.48 3.48 TUBE 2 TUBE CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5231BV KETOCONAZOLE 2% CR (HEA/RXP) KETOCONAZOLE KETOCONAZOLE 15G A 1.90 1.90 CREAM 2 TUBE HEA HEALTH 2000 INC RXP RX PRO INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5231CC KETOCONAZOLE 2% CR (HEA/ATB) KETOCONAZOLE KETOCONAZOLE 15G A 1.9 1.9 CREAM HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2022-12-07 2024-03-31 Change Local Agent Topical 0 ANTIFUNGALS TOPICAL 2022-11-25
41 5231CC KETOCONAZOLE 2% CR (HEA) KETOCONAZOLE KETOCONAZOLE 15G A 1.96 1.9572 TUBE 2 TUBE HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 Topical 0 ANTIFUNGALS TOPICAL
41 5231EZ KETOMED 2% CR (TPP) KETOCONAZOLE KETOCONAZOLE KETOMED 15G A 1.9 1.9028 TUBE 2 TUBE TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231GC KETOCONAZOLE 2% CR (HEA) KETOCONAZOLE KETOCONAZOLE 15G A 1.88 1.88 TUBE 2 TUBE HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 840408 ANTIFUNGALS TOPICAL 2026-04-01 Add to Contract as Cat A TOPICAL 0 ANTIFUNGALS TOPICAL 2026-01-26
42 5231GD KETOCONAZOLE 2% CR (HEA) KETOCONAZOLE KETOCONAZOLE 15G A 1.88 1.88 TUBE 2 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2026-04-01 Add to Contract as Cat A TOPICAL 0 ANTIFUNGALS TOPICAL 2026-02-27
42 5231GE KETOCONAZOLE 2% CR (CHC) KETOCONAZOLE KETOCONAZOLE 20G A 1.88 1.88 TUBE 2 CHC CARITAS HEALTHCARE PVT LTD STO BRYDEN STOKES LTD 840408 ANTIFUNGALS TOPICAL 2026-04-01 Add to Contract as Cat A TOPICAL 0 ANTIFUNGALS TOPICAL 2026-03-05
40 5231ZG KETOZAL 2% CR (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 45G C 8.56 8.56 CREAM 0 TUBE CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5231ZG KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 45G C 8.64 8.6443 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIFUNGALS TOPICAL
42 5231ZG KETOZAL 2% CR (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 45G C 8.89 8.89 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840408 ANTIFUNGALS TOPICAL 2026-04-01 TOPICAL 0 ANTIFUNGALS TOPICAL
40 5232BA KETOCONAZOLE 2% SHAMP (HEA/RXP) KETOCONAZOLE KETOCONAZOLE 100ML A 4.84 0.05 SHAMPOO 100 ML HEA HEALTH 2000 INC RXP RX PRO INC 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 6 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 5232BE KETOZAL 2% SHAMP (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 250ML C 20.66 0.08 SHAMPOO 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 5232BE KETOZAL 2% SHAMP (CAR) KETOCONAZOLE (C) KETOCONAZOLE KETOZAL 250ML C 21.69 0.0868 ML 100 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 081404 ALLYAMINES 2024-04-01 2026-03-31 TOPICAL 6 ALLYAMINES
42 5232BE KETOZAL 2% SHAMP (CAR) KETOCONAZOL (C) KETOCONAZOLE KETOZAL 250ML C 21.69 0.09 ML 100 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 081404 ALLYAMINES 2026-04-01 TOPICAL 6 ALLYAMINES
40 5232BJ KETOZAL 2% SHAMP (CAR/COL) KETOCONAZOLE KETOCONAZOLE KETOZAL 125ML C 10.47 0.08 SHAMPOO 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840408 ANTIFUNGALS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS