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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 A321AK APO-SERTRALINE 50MG CAP (APO) SERTRALINE APO-SERTRALINE 100'S A 12.15 0.12 CAP 42 BOTT APO APOTEX INC. COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A321AL ZOLOFT 50MG TAB (PFI) SERTRALINE SERTRALINE ZOLOFT 14'S C 19.68 1.41 TAB 42 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 ORAL 0 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A321AT SETMAX 50MG TAB (JLP) SERTRALINE SERTRALINE SETMAX 10X10 A 12.23 0.12 TAB 42 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 28160492 ANTIDEPRESSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTIDEPRESSANTS MISCELLANEOUS
40 A322AA APO-SERTRALINE 50MG CAP (APO/COL) SERTRALINE APO-SERTRALINE 100'S A 11.91 0.12 CAPSULE 30 CAP APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
40 A322AF ZOLOFT 50MG TAB (PFI/STO) SERTRALINE SERTRALINE ZOLOFT 14'S C 19.49 1.39 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322AF ZOLOFT 50MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 19.68 1.4058 TAB 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322AY ZOLOFT 100MG TAB (PFI/STO) SERTRALINE SERTRALINE ZOLOFT 14'S C 29.25 2.09 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322AY ZOLOFT 100MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 29.49 2.1067 TAB 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322CJ APO-SERTRALINE 100MG CAP (APO/COL) SERTRALINE APO-SERTRALINE 100'S A 19.03 0.19 CAPSULE 30 CAP APO APOTEX INC. COL COLLINS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
42 A322CJ APO-SERTRALINE 100MG CAP (APO) SERTRALINE APO-SERTRALINE 100'S A 19.41 0.19 CAP 42 BOTT APO APOTEX INC. COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322CL ZOLOFT 100MG TAB (PFI/SBI) SERTRALINE SERTRALINE ZOLOFT 14'S C 29.25 2.09 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322CL ZOLOFT 100MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 29.49 2.1067 TAB 42 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
40 A322CM ZOLOFT 50MG TAB (PFI/SBI) SERTRALINE SERTRALINE ZOLOFT 14'S C 19.49 1.39 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 A322CM ZOLOFT 50MG TAB (PFI) SERTRALINE (C) SERTRALINE ZOLOFT 14'S C 19.68 1.4058 TAB 42 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
41 A322LE APO-SERTRALINE 50MG CAP (APO) SERTRALINE SERTRALINE APO-SERTRALINE 100'S A 12.15 0.1215 CAP 42 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
41 A322LF APO-SERTRALINE 100MG CAP (APO) SERTRALINE APO-SERTRALINE 100'S A 19.41 0.1941 CAP 42 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS
42 A322MM ZOLOFT 100MG TAB (PFI) SERTRALINE SERTRALINE ZOLOFT 14'S C 37.54 2.68 TAB 42 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 28160420 SELECTIVE SEROTONIN REUPTAKE INHIBITORS 2026-04-01 ORAL 6 SELECTIVE SEROTONIN REUPTAKE INHIBITORS