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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 7911Q TIZANIDINE 4MG TAB (DRL) TIZANIDINE TIZANIDINE 150'S A 17.51 0.1167 TAB 21 BOX DRL DR. REDDY'S LABORATORIES LTD AHI ARMSTRONG HEALTHCARE INC 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 0 NEUROMUSCULAR BLOCKING AGENTS
40 7911T TIZANIDINE 4MG TAB (KWA/ATB) TIZANIDINE TIZANIDINE 10X10 A 30.47 0.30 TABLET 21 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 7911Y SIRDALUD 4MG TAB (BCH/COL) TIZANIDINE TIZANIDINE SIRDALUD 30'S C 20.44 0.68 TABLET 0 TAB BCH SANDOZ COL COLLINS LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 7911Y SIRDALUD 4MG TAB (BCH) TIZANIDINE (C) TIZANIDINE SIRDALUD 30'S C 20.44 0.6814 TAB 21 BOX BCH SANDOZ COL COLLINS LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 0 NEUROMUSCULAR BLOCKING AGENTS