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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 60914 AAP-PENTOXIFYLLINE SR 400MG TAB (APO/COL) PENTOXIFYLLINE AAP-PENTOXIFYLLINE SR 100'S C 23.65 0.24 TABLET 0 TAB APO APOTEX INC. COL COLLINS LTD 2024 HEMORRHEOLOGICS 2022-04-01 2024-03-31 Name Change Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-04-04
40 60917 PENTOXIFYLLINE 400MG TAB (HEA/RXP) PENTOXIFYLLINE PENTOXIFYLLINE 10X10 A 21.18 0.21 TABLET 90 TAB HEA HEALTH 2000 INC RXP RX PRO INC 2024 HEMORRHEOLOGICS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 6091B AAP-PENTOXIFYLLINE SR 400MG TAB (APO) PENTOXIFYLLINE AAP-PENTOXIFYLLINE 100'S A 19.11 0.1911 TAB 90 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 2024 HEMORRHEOLOGICS 2024-04-01 2026-03-31 ORAL 6 HEMORRHEOLOGICS
40 6091F PENTOXIFYLLINE 400MG TAB (KWA/ATB) PENTOXIFYLLINE PENTOXIFYLLINE 10X10 A 18.73 0.19 TABLET 90 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 2024 HEMORRHEOLOGICS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 6091F PENTOXIFYLLINE 400MG TAB (KWA) PENTOXIFYLLINE PENTOXIFYLLINE 10X10 A 23.57 0.2357 TAB 90 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 2024 HEMORRHEOLOGICS 2024-04-01 2026-03-31 ORAL 6 HEMORRHEOLOGICS
40 6091G PENTOXIFYLLINE 400MG TAB (HEA/ATB) PENTOXIFYLLINE PENTOXIFYLLINE 10X10 A 21.18 0.2118 TABLET IMMED 90 HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 2024 HEMORRHEOLOGICS 2022-07-12 2024-03-31 la oral 6 HEMORRHEOLOGICS 2022-11-25
41 6091G PENTOXIFYLLINE 400MG TAB (HEA) PENTOXIFYLLINE PENTOXIFYLLINE 10X10 A 27.51 0.2751 TAB 90 BOX HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 2024 HEMORRHEOLOGICS 2024-04-01 2026-03-31 ORAL 6 HEMORRHEOLOGICS