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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 19311 VIAGRA 100MG TAB (PFI/STO) SILDENAFIL SILDENAFIL VIAGRA 1'S C 16.96 16.96 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19311 VIAGRA 100MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 1'S C 17.53 17.5332 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19312 VIAGRA 100MG TAB (PFI/STO) SILDENAFIL SILDENAFIL VIAGRA 4'S C 55.45 13.86 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19312 VIAGRA 100MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 4'S C 57.36 14.3392 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19313 VIAGRA 100MG TAB (PFI/SBI) SILDENAFIL SILDENAFIL VIAGRA 1'S C 16.96 16.96 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19313 VIAGRA 100MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 1'S C 17.53 17.5332 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19314 VIAGRA 100MG TAB (PFI/SBI) SILDENAFIL SILDENAFIL VIAGRA 4'S C 55.45 13.86 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19314 VIAGRA 100MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 4'S C 57.36 14.3392 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
41 1931AM SILDENAFIL 100MG TAB (RYV) (BQ) SILDENAFIL SILDENAFIL 4'S BQ 2.64 0.6592 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 1931AP SILDENAFIL 100MG TAB (MCP/AHI) SILDENAFIL SILDENAFIL 4'S BQ 1.52 0.38 TABLET 0 TAB MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
42 1931AP SILDENAFIL 100MG TAB (MCP) SILDENAFIL SILDENAFIL 4'S BQ 0.95 0.24 TAB 30 BLIS MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 241212 PHOSPHODIESTERASE INHIBITORS 2026-04-01 ORAL 0 PHOSPHODIESTERASE INHIBITORS
41 1931AX MYGRA 100MG TAB (SKH) SILDENAFIL (BQ) SILDENAFIL MYGRA 4'S BQ 1.39 0.3466 TAB 30 BOX SKH S. KANT HEALTHCARE LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
42 1931AZ VIAGRA 100MG TAB (PFI) SILDENAFIL SILDENAFIL VIAGRA 4'S C 57.36 14.34 TAB 30 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 241212 PHOSPHODIESTERASE INHIBITORS 2026-04-01 ORAL 6 PHOSPHODIESTERASE INHIBITORS
41 1931S XCITE 100MG TAB (GPC) SILDENAFIL (BQ) SILDENAFIL XCITE 4'S BQ 1.2 0.299 TAB 30 BOTT GPC NEW GUYANA PHARMACEUTICAL CORP. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19321 VIAGRA 50MG TAB (PFI/STO) SILDENAFIL SILDENAFIL VIAGRA 1'S C 16.04 16.04 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19321 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 1'S C 16.58 16.5818 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19322 VIAGRA 50MG TAB (PFI/STO) SILDENAFIL SILDENAFIL VIAGRA 4'S C 56.62 14.16 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19322 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 4'S C 58.58 14.645 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
40 19323 VIAGRA 50MG TAB (PFI/SBI) SILDENAFIL SILDENAFIL VIAGRA 1'S C 16.04 16.04 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 19323 VIAGRA 50MG TAB (PFI) SILDENAFIL (C) SILDENAFIL VIAGRA 1'S C 16.58 16.5818 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS