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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 4141FX PONSTAN FORTE 500MG TAB (PFI/STO) MEFENAMIC A MEFENAMIC ACID PONSTAN FORTE 50'S C 15.14 0.30 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 4141FX PONSTAN FORTE 500MG TAB (PFI) MEFEN (C) MEFENAMIC ACID PONSTAN FORTE 50'S C 15.28 0.3055 TAB 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
42 4141FX PONSTAN FORTE 500MG TAB (PFI) MEFEN MEFENAMIC ACID PONSTAN FORTE 50'S C 15.28 0.31 TAB 0 BLIS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2026-04-01 ORAL 0 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS