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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 5832F CONTINE CR 200MG TAB (ARP/AHI) THEOPHYLLINE THEOPHYLLINE CONTINE CR 10X10 A 8.13 0.08 TABLET 90 TAB ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC B 8616 THEOPHYLLINES 2022-04-01 2024-03-31 Oral 6 SMOOTH MUSCLE RELAXANTS
41 5832F CONTINE CR 200MG TAB (ARP) THEOPHYL THEOPHYLLINE CONTINE CR 10X10 A 10 0.1 TAB 90 BOX ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC B 8616 THEOPHYLLINES 2024-04-01 2026-03-31 ORAL 6 THEOPHYLLINES
42 5832F CONTINE CR 200MG TAB (ARP) THEOPHYL THEOPHYLLINE CONTINE CR 10X10 A 10.68 0.11 TAB 90 BLIS ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC B 8616 THEOPHYLLINES 2026-04-01 ORAL 6 THEOPHYLLINES