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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 4622S LORAZEPAM 2MG/ML INJ (KWA/ATB) LORAZEPAM LORAZEPAM 10X1ML B 38.19 3.82 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 282408 BENZODIAZEPINES (SEDATIVES) 2022-04-01 2024-03-31 IM 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-30
41 4622S LORAZEPAM 2MG/ML INJ (KWA) (B) LORAZEPAM LORAZEPAM 10X1ML B 30.91 3.0907 VIAL 1 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 IM 0 BENZODIAZEPINES (SEDATIVES)
40 4622U LORAZEPAM 2MG/ML INJ (FSB/ATB) LORAZEPAM LORAZEPAM 1ML VIAL B 4.02 4.02 INJECTION 0 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 282408 BENZODIAZEPINES (SEDATIVES) 2022-05-27 2024-03-31 Price Change IV 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-05-27
40 46255 APO-LORAZEPAM 1MG TAB (APO/COL) LORAZEPAM APO-LORAZEPAM 1000'S A 38.06 0.04 TABLET 240 TAB APO APOTEX INC. COL COLLINS LTD 282408 BENZODIAZEPINES (SEDATIVES) 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 46255 APO-LORAZEPAM 1MG TAB (APO) LORAZEP LORAZEPAM APO-LORAZEPAM 1000'S A 38.82 0.04 TAB 240 BOTT APO APOTEX INC. COL AVENTA BARBADOS 282408 BENZODIAZEPINES (SEDATIVES) 2026-04-01 ORAL 6 BENZODIAZEPINES (SEDATIVES)
40 46259 LORIVAN 1MG TAB (REM/SBI) LORAZEPAM LORAZEPAM LORIVAN 100x10 A 34.41 0.03 TABLET 240 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 282408 BENZODIAZEPINES (SEDATIVES) 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 46259 LORIVAN 1MG TAB (REM) LORAZEPAM LORAZEPAM LORIVAN 100X10 A 33.16 0.0332 TAB 240 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 ORAL 6 BENZODIAZEPINES (SEDATIVES)
40 4625B LORIVAN 1MG TAB (REM/SBI) LORAZEPAM LORAZEPAM LORIVAN 10x10 C 4.84 0.05 TABLET 0 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 282408 BENZODIAZEPINES (SEDATIVES) 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 4625B LORIVAN 1MG TAB (REM) LORAZEPAM LORAZEPAM LORIVAN 10X10 A 3.13 0.0313 TAB 240 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 ORAL 6 BENZODIAZEPINES (SEDATIVES)
42 4625B LORIVAN 1MG TAB (REM) LORAZEPAM LORAZEPAM LORIVAN 10X10 A 4.00 0.04 TAB 240 BLIS REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 282408 BENZODIAZEPINES (SEDATIVES) 2026-04-01 ORAL 6 BENZODIAZEPINES (SEDATIVES)
41 4625E APO-LORAZEPAM 1MG TAB (APO) LORAZEP LORAZEPAM APO-LORAZEPAM 1000'S A 38.82 0.0388 TAB 240 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 282408 BENZODIAZEPINES (SEDATIVES) 2024-04-01 2026-03-31 ORAL 6 BENZODIAZEPINES (SEDATIVES)