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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 5172T LEVAM 8MG/ML SYR (FED/ATB) LEVAMISOLE LEVAM 30ML C 3.15 0.11 SYRUP 0 ML FED FEDERATED PHARMACEUTICAL CO. LT ATB ANSA TRADING BARBADOS LTD 0808 ANTHELMINTICS 2022-04-01 2022-05-11 Delete from contract Oral 0 ANTI-INFECTIVE AGENTS 2022-05-11
40 5172T LEVAM 8MG/ML SYR (FED/ATB) LEVAMISOLE LEVAM 30ML C 3.15 0.11 SYRUP 0 ML FED FEDERATED PHARMACEUTICAL CO. LT ATB ANSA TRADING BARBADOS LTD 0808 ANTHELMINTICS 2022-05-11 2024-03-31 Change Local Agent Oral 0 ANTI-INFECTIVE AGENTS 2022-05-11
41 5172T LEVAM 8MG/ML SYR (FED) (C) LEVAMISOLE LEVAM 30ML C 4.62 0.154 ML 0 BOTT FED FEDERATED PHARMACEUTICAL CO. LT ATB ANSA TRADING BARBADOS LTD 9244 IMMUNOSUPPRESSIVE AGENTS 2024-04-01 2026-03-31 ORAL 0 IMMUNOSUPPRESSIVE AGENTS