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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 35911 LAMICTAL 25MG TAB (GSK/COL) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 41.37 1.38 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 35911 LAMICTAL 25MG TAB (GSK) LAMOTRIGINE (C) LAMOTRIGINE LAMICTAL 30'S C 45.48 1.5159 TAB 60 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 35911 LAMICTAL 25MG TAB (GSK) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 47.73 1.59 TAB 60 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3591F APO-LAMOTRIGINE 25MG TAB (APO) LAMO LAMOTRIGINE APO-LAMOTRIGINE 100'S B 10.41 0.10 TAB 60 BOTT APO APOTEX INC. COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 3591G PMS-LAMOTRIGINE 25MG TAB (PMS/COL) LAMOTRIGINE PMS-LAMOTRIGINE 100'S B 13.59 0.14 TABLET 0 TAB PMS PHARMASCIENCE COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 3591Q APO-LAMOTRIGINE 25MG TAB (APO) LAMO (B) LAMOTRIGINE APO-LAMOTRIGINE 100'S B 10.41 0.1041 TAB 60 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3591T LEMOGIN 25MG DISP TAB (JLP) LAMOTRIGINE LAMOTRIGINE LEMOGIN 20X10 B 23.11 0.12 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 0 ANTICONVULSANTS MISCELLANEOUS
40 35921 LAMICTAL 50MG TAB (GSK/COL) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 81.20 2.71 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 35921 LAMICTAL 50MG TAB (GSK) LAMOTRIGINE (B) LAMOTRIGINE LAMICTAL 30'S B 89.35 2.9784 TAB 60 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 35921 LAMICTAL 50MG TAB (GSK) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 98.40 3.28 TAB 60 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 3592D LAMEZ 50MG TAB (INP/AAL) LAMOTRIGINE LAMOTRIGINE LAMEZ 56'S B 58.28 1.04 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AAL A. A. LAQUIS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 3592G LEMOGIN 50MG DISP TAB (JLP) LAMOTRIGINE LAMOTRIGINE LEMOGIN 20X10 B 24.46 0.12 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 0 ANTICONVULSANTS MISCELLANEOUS
40 35931 LAMICTAL 100MG TAB (GSK/COL) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 89.46 2.98 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 35931 LAMICTAL 100MG TAB (GSK) LAMOTRIGINE (C) LAMOTRIGINE LAMICTAL 30'S C 98.4 3.2801 TAB 60 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 35931 LAMICTAL 100MG TAB (GSK) LAMOTRIGINE LAMOTRIGINE LAMICTAL 30'S C 103.30 3.44 TAB 60 BLIS GSK GLAXOSMITHKLINE COL AVENTA BARBADOS B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 3593G APO-LAMOTRIGINE 100MG TAB (APO/COL) LAMOTRIGINE APO-LAMOTRIGINE 100'S B 25.93 0.26 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 3593M APO-LAMOTRIGINE 100MG TAB (APO) LAM (B) LAMOTRIGINE APO-LAMOTRIGINE 100'S B 26.45 0.2645 TAB 60 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3593N LEMOGIN 100MG DISP TAB (JLP) LAMOTRIGINE LAMOTRIGINE LEMOGIN 20X10 B 25.82 0.13 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 0 ANTICONVULSANTS MISCELLANEOUS