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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 0012EP CLARITINE 10MG TAB (BSP) LORATADINE (C) LORATADINE CLARITINE 30'S C 13.21 0.4404 TAB 14 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2025-01-28 ORAL 0 SECOND GENERATION ANTIHISTAMINES
41 0012EP CLARITINE 10MG TAB (BSP) LORATADINE (C) LORATADINE CLARITINE 30'S C 31.8 1.06 TAB 14 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-08-09 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES 2024-08-09
41 0012ES RHINIL SR 10MG TAB (ARP) CETIRIZINE CETIRIZINE RHINIL SR 100'S A 7.42 0.0742 TAB 14 BOX ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012ES RHINIL SR 10MG TAB (ARP) CETIRIZINE CETIRIZINE RHINIL SR 100'S A 7.48 0.07 TAB 14 BLIS ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
40 0012FA LORATADINE 10MG TAB (AUR/AHI) LORATADINE LORATADINE 100'S A 8.26 0.08 TABLET 14 TAB AUR AUROCHEM LABORATORIES AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0012FN CETVAN 10MG TAB (TPP) CETIRIZINE CETIRIZINE CETVAN 10X10 A 5.44 0.0544 TAB 14 BOX TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
41 0012FP LORATADINE 10MG TAB (MCP) LORATADINE LORATADINE 10X10 A 6.9 0.069 TAB 14 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2024-12-27 OTIC 0 SECOND GENERATION ANTIHISTAMINES
41 0012FP LORATADINE 10MG TAB (MCP) LORATADINE LORATADINE 10X10 A 7.85 0.0785 TAB 14 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-12-28 2026-03-31 OTIC 0 SECOND GENERATION ANTIHISTAMINES 2024-12-27
41 0012FQ LORDINE 10MG TAB (TPP) LORATADINE LORATADINE LORDINE 10X10 A 5.33 0.0533 TAB 14 BOX TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012FQ LORDINE 10MG TAB (TPP) LORATADINE LORATADINE LORDINE 10X10 A 6.12 0.06 TAB 14 BLIS TPP THERDOSE PHARMA PRIVATE LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
41 0012FR AXOFEN 120MG TAB (ARP) FEXOFENADINE (C) FEXOFENADINE AXOFEN 30'S C 23.27 0.7756 TAB 0 BOX ARP ARISTOPHARMA LTD AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012GR FEEGRA 120MG SR TAB (JLP) FEXOFENADINE FEXOFENADINE FEEGRA 10X10 C 27.18 0.27 TAB 0 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
40 0013AZ LEVOCETIRIZINE 2.5MG/ML SYR (CIR/AHI) LEVOCETIRIZINE LEVOCETIRIZINE 60ML C 5.71 0.10 SYRUP 0 ML CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
40 0013BP CLARITINE 10MG TAB (BSP/AHI) LORATADINE (C) LORATADINE CLARITINE 30'S C 9.51 0.317 TABLET CONTR BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 408 SECOND GENERATION ANTIHISTAMINES 2023-02-21 2023-04-07 Add to Contract as Cat C Oral SECOND GENERATION ANTIHISTAMINES 2023-02-24
42 0013BT CETIRIZINE 1MG/ML SOLN (HEA) CETIRIZINE CETIRIZINE 60ML A 2.83 0.05 ML 60 BOTT HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 Price Change ORAL 0 SECOND GENERATION ANTIHISTAMINES 2025-10-31
42 0013BU LORATADINE 1MG/ML SOLN (HEA) LORATADINE LORATADINE 100ML A 3.13 0.03 ML 60 BOTT HEA HEALTH 2000 INC AHI ARMSTRONG HEALTHCARE INC 0404 FIRST GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 FIRST GENERATION ANTIHISTAMINES
42 0014U JONCPM 10MG/ML IV/IM INJ (JLP) CHLORPHENIRAMINE CHLORPHENIRAMINE JONCPM 10X1ML B 3.26 0.33 AMPG 30 AMP JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 0404 FIRST GENERATION ANTIHISTAMINES 2026-04-01 IV/IM/SC 6 FIRST GENERATION ANTIHISTAMINES
40 0051F CAPECITABINE 150MG TAB (INP/AHI) CAPECITABINE CAPECITABINE 6X10 BQ 194.20 3.24 TABLET 0 TAB INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 0051J CAPECITABINE 150MG TAB (WAT) CAPECITABINE CAPECITABINE 60'S BQ 175.3319 2.9222 TAB 230 BOTT WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
42 0051M CAPECITABINE 150MG TAB (INP) CAPECITABINE CAPECITABINE 10'S BQ 15.79 1.58 TAB 230 PACK INP INTAS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 1000 ANTINEOPLASTICS 2026-04-01 ORAL 0 ANTINEOPLASTICS