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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 | 34915 | LAVIT-6 50MG TAB (LDP/AHI) PYRIDOXINE | PYRIDOXINE | LAVIT-6 | 100'S | B | 17.75 | 0.18 | TABLET | 0 | TAB | LDP | LABDHI PHARMA | AHI | ARMSTRONG HEALTHCARE INC | 8808 | VITAMIN B COMPLEX | 2022-04-01 | 2024-03-31 | Oral | 0 | VITAMINS | |||||
| 41 | 34915 | LAVIT-6 50MG TAB (LDP) PYRIDOXINE | PYRIDOXINE | LAVIT-6 | 100'S | B | 17.75 | 0.1775 | TAB | 150 | BOX | LDP | LABDHI PHARMA | AHI | ARMSTRONG HEALTHCARE INC | 8808 | VITAMIN B COMPLEX | 2024-04-01 | 2026-03-31 | ORAL | 6 | VITAMIN B COMPLEX | |||||
| 41 | 3532B | VITAPLEX M SYR (CAR) MULTIVITAMINS (B) | CALCIUM|CYANOCOBALAMIN|IODINE|IRON ELEME <...> OSPHOROUS|POTASSIUM|PYRIDOXIN More ... | VITAPLEX M | 250ML | B | 14.41 | 0.0576 | ML | 150 | BOTT | CAR | CARLISLE LABORATORIES LTD | COL | COLLINS LTD | 8828 | MULTIVITAMIN PREPARATIONS | 2024-04-01 | 2026-03-31 | ORAL | 6 | MULTIVITAMIN PREPARATIONS | |||||
| 42 | 3544D | IN FUVITE PAED INJ (BAX) MULTIVITAMINS | BIOTIN|CYANOCOBALAMIN|FOLIC ACID|NICOTINAMIDE|PYRIDOXINE|RIBOFLAVIN|THIAMINE|VIT More ... | IN FUVITE PAED | 5 PAIRS | B | 332.23 | 66.45 | AMPG | 0 | BOX | BAX | BAXTER EXPORT CORP. | STO | BRYDEN STOKES LTD | 8828 | MULTIVITAMIN PREPARATIONS | 2026-04-01 | IV | 0 | MULTIVITAMIN PREPARATIONS | ||||||