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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 B041AU ALOCID 20MG CAP (CAR/COL) OMEPRAZOLE OMEPRAZOLE ALOCID 3X10 C 5.44 0.18 CAPSULE 0 CAP CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 B041AU ALOCID 20MG CAP (CAR) OMEPRAZOLE (C) OMEPRAZOLE ALOCID 3X10 C 5.44 0.1812 CAP 30 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PROTON PUMP INHIBITORS
42 B041AU ALOCID 20MG CAP (CAR) OMEPRAZOLE OMEPRAZOLE ALOCID 3X10 A 5.93 0.20 CAP 60 BLIS CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 6 PROTON PUMP INHIBITORS
40 B041EL OMEPRAZOLE 20MG CAP (HEA/ATB) OMEPRAZOLE OMEPRAZOLE 30'S A 1.9 0.0633 CAPSULE HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2022-12-07 2024-03-31 Change Local Agent oral 6 PROTON PUMP INHIBITORS 2022-11-25
41 B041EL OMEPRAZOLE 20MG CAP (HEA) (C) OMEPRAZOLE OMEPRAZOLE 30'S C 2.28 0.0761 CAP 30 BOX HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PROTON PUMP INHIBITORS
40 B041EP OMEPRAZOLE 20MG CAP (HEA/RXP) OMEPRAZOLE OMEPRAZOLE 30'S A 1.90 0.06 CAPSULE 30 CAP HEA HEALTH 2000 INC RXP RX PRO INC 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS
40 B041JL NEXIUM 20MG TAB (AZN/COL) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 41.59 1.49 TABLET 0 TAB AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 B041JL NEXIUM 20MG TAB (AZN) ESOMEPRAZOLE (C) ESOMEPRAZOLE NEXIUM 28'S C 40.67 1.4524 TAB 0 BOX AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS
42 B041JL NEXIUM 20MG TAB (AZN) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 40.77 1.46 TAB 0 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 0 PROTON PUMP INHIBITORS
40 B041JM NEXIUM 40MG TAB (AZN/COL) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 52.25 1.87 TABLET 0 TAB AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 B041JM NEXIUM 40MG TAB (AZN) ESOMEPRAZOLE (C) ESOMEPRAZOLE NEXIUM 28'S C 52.25 1.8659 TAB 0 BOX AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS
42 B041JM NEXIUM 40MG TAB (AZN) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 55.05 1.97 TAB 0 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 0 PROTON PUMP INHIBITORS
42 B041KZ GASTRIC EZE 20MG CAP (INF) OMEPRAZOLE OMEPRAZOLE GASTRIC EZE 3X10 A 2.23 0.07 CAP 60 BLIS INF INFOCUS REMEDIES PVT RXP RX PRO INC 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 6 PROTON PUMP INHIBITORS
40 B041LE NEXIUM 10MG GRAN (AZN/COL) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 47.71 1.70 GRANULES 0 TAB AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
42 B041LE NEXIUM 10MG GRAN (AZN) ESOMEPRAZOLE ESOMEPRAZOLE NEXIUM 28'S C 47.84 1.71 TAB 0 BLIS AZN ASTRAZENECA AB COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 0 PROTON PUMP INHIBITORS
40 B041LG ESOMEPRAZOLE 20MG TAB (KWA/ATB) ESOMEPRAZOLE ESOMEPRAZOLE 10X10 C 19.03 0.19 TABLET 0 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
40 B041LQ EMEP 40MG CAP (ARP/AHI) ESOMEPRAZOLE ESOMEPRAZOLE EMEP 40'S C 16.36 0.41 CAPSULE 0 CAP ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Add to Contract as Cat C Oral 0 GASTROINTESTINAL DRUGS 2022-03-10
40 B041MH OMEPRAZOLE 20MG TAB (MCP/AHI) OMEPRAZOLE OMEPRAZOLE 2X10 A 0.76 0.04 TABLET 30 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS
41 B041MH OMEPRAZOLE 20MG TAB (MCP) OMEPRAZOLE OMEPRAZOLE 2X10 A 0.9 0.0448 TAB 30 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PROTON PUMP INHIBITORS
40 B041NJ OMEPRAZOLE 20MG CAP (FSB/ATB) OMEPRAZOLE OMEPRAZOLE 100'S A 6.80 0.07 CAPSULE 30 CAP FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 Add to Contract as Cat A Oral 6 GASTROINTESTINAL DRUGS 2021-12-03