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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 A9811 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) RILMENIDINE HYPERIUM 30'S C 22.15 0.7385 TAB 60 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 HYPOTENSIVE AGENTS, MISCELLANEOUS
41 A9812 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) RILMENIDINE HYPERIUM 30'S C 22.15 0.7385 TAB 60 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD B 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 HYPOTENSIVE AGENTS, MISCELLANEOUS
40 A9813 RILMENIDINE 1MG TAB (KWA/ATB) RILMENIDINE RILMENIDINE 3X10 C 97.86 3.26 TABLET 0 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS