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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
42 B041CF APO-PANTOPRAZOLE 40MG TAB (APO) PANTOPRAZOLE APO-PANTOPRAZOLE 100'S C 14.11 0.14 TAB 7 BOTT APO APOTEX INC. COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 ORAL 0 PROTON PUMP INHIBITORS
40 B041JH PANTOPRAZOLE 20MG TAB (KWA/ATB) PANTOPRAZOLE PANTOPRAZOLE 10X10 C 9.38 0.09 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 B041LH PANTOPRAZOLE 40MG TAB (KWA/ATB) PANTOPRAZOLE PANTOPRAZOLE 100'S C 9.38 0.09 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
41 B041LS PROTON-P 20MG TAB (ARP) PANTOPRAZOL (C) PANTOPRAZOLE PROTON-P 60'S C 9.54 0.159 TAB 0 BOX ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS
41 B041NR APO-PANTOPRAZOLE 40MG TAB (APO) (C) PANTOPRAZOLE APO-PANTOPRAZOLE 100'S C 14.11 0.1411 TAB 7 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 ORAL 0 PROTON PUMP INHIBITORS
40 B0427 PANTOPRAZOLE 40MG INJ (CIP/AHI) PANTOPRAZOLE PANTOPRAZOLE 40MG VIAL B 2.61 2.61 INJECTION 0 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2022-04-01 2022-09-30 IV 0 GASTROINTESTINAL DRUGS 2022-03-29
42 B0427 PANTOPRAZOLE 40MG INJ (CIP) PANTOPRAZOLE PANTOPRAZOLE 40MG VIAL B 1.55 1.55 VIAL 7 VIAL CIP CIPLA LTD AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2026-04-01 IV 0 PROTON PUMP INHIBITORS
41 B042AN PANTOPRAZOLE 40MG INJ (FSB) (B) PANTOPRAZOLE PANTOPRAZOLE 40MG VIAL B 1.14 1.1417 VIAL 7 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 IV 0 PROTON PUMP INHIBITORS
40 B042AV PANSALVE 40MG INJ (EMC/COL) PANTOPRAZOLE PANTOPRAZOLE PANSALVE 40MG VIAL B 1.17 1.17 INJECTION 0 VIAL EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-04-01 2024-03-31 IV 0 GASTROINTESTINAL DRUGS
40 B042BL NEXIUM 40MG INJ (AZN/COL) PANTOPRAZOLE PANTOPRAZOLE NEXIUM 5ML VIAL C 14.68 14.68 INJECTION 0 VIAL AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2022-05-04 2024-03-31 Package Size Change ORAL 0 GASTROINTESTINAL DRUGS 2022-05-04
41 B042BL NEXIUM 40MG INJ (AZN) PANTOPRAZOLE (B) PANTOPRAZOLE NEXIUM 5ML VIAL B 14.35 14.3528 VIAL 7 VIAL AZN ASTRAZENECA AB COL COLLINS LTD 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 IV 0 PROTON PUMP INHIBITORS
42 B042BL NEXIUM 40MG INJ (AZN) PANTOPRAZOLE PANTOPRAZOLE NEXIUM 5ML VIAL C 14.35 14.35 VIAL 7 VIAL AZN ASTRAZENECA AB COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 IV 0 PROTON PUMP INHIBITORS
41 B042BX LASPRAZOLE 40MG INJ (LDP) PANTOPRAZOLE (B) PANTOPRAZOLE LASPRAZOLE 10X10ML B 26.75 2.6748 VIAL 7 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 562836 PROTON PUMP INHIBITORS 2024-04-01 2026-03-31 IV 0 PROTON PUMP INHIBITORS
42 B042BZ PANTOPRAZOLE 40MG INJ (ZHL) PANTOPRAZOLE PANTOPRAZOLE 40MG VIAL B 2.45 2.45 VIAL 7 VIAL ZHL ZENITH HEALTHCARE LIMITED SBI MASSY DISTRIBUTION (BDOS) LTD 562836 PROTON PUMP INHIBITORS 2026-04-01 IV 0 PROTON PUMP INHIBITORS
42 B042CA PARIDEM 40MG INJ (EMC) PANTOPRAZOLE PANTOPRAZOLE PARIDEM 40MG VIAL B 4.89 4.89 VIAL 7 VIAL EMC EMCURE PHARMACEUTICALS LTD COL AVENTA BARBADOS 562836 PROTON PUMP INHIBITORS 2026-04-01 IV 0 PROTON PUMP INHIBITORS