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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
41 39111 MINOXIDIL 2.5MG TAB (WAT) MINOXIDIL MINOXIDIL 100'S A 14.6 0.146 TAB 120 BOTT WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
40 3911C MINOXIDIL 2.5MG TAB (KWA/ATB) MINOXIDIL MINOXIDIL 10X10 A 38.06 0.38 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 240820 DIRECT VASODILATOR 2022-04-01 2022-04-02 Oral 6 CARDIOVASCULAR DRUGS
40 3911C MINOXIDIL 2.5MG TAB (KWA/ATB) MINOXIDIL MINOXIDIL 10X10 A 56.79 0.57 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 240820 DIRECT VASODILATOR 2022-04-03 2024-03-31 Price Change Oral 6 CARDIOVASCULAR DRUGS 2022-06-14
42 3911F MINOXYQURE 2.5MG TAB (JLP) MINOXIDIL MINOXIDIL MINOXYQURE 10X10 A 11.96 0.12 TAB 120 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 240820 DIRECT VASODILATOR 2026-04-01 ORAL 6 DIRECT VASODILATOR
41 39127 MINOXIDIL 10MG TAB (WAT) MINOXIDIL MINOXIDIL 100'S A 21.15 0.2115 TAB 120 BOX WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 240820 DIRECT VASODILATOR 2024-04-01 2026-03-31 ORAL 6 DIRECT VASODILATOR
40 3912F MINOXIDIL 10MG TAB (KWA/ATB) MINOXIDIL MINOXIDIL 10X10 A 48.93 0.49 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 240820 DIRECT VASODILATOR 2022-04-01 2022-04-02 Oral 6 CARDIOVASCULAR DRUGS
40 3912F MINOXIDIL 10MG TAB (KWA/ATB) MINOXIDIL MINOXIDIL 10X10 A 93.13 0.93 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD B 240820 DIRECT VASODILATOR 2022-04-03 2024-03-31 Price Change Oral 6 CARDIOVASCULAR DRUGS 2022-06-14