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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
40 0012EX CLARITYNE 10MG TAB (BSP/COL) LORATADINE LORATADINE CLARITYNE 30'S C 9.51 0.32 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0012EX CLARTYNE 10MG TAB (BSP) LORATADINE (C) LORATADINE CLARTYNE 30'S C 31.8 1.0601 TAB 14 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
41 0012FH CLARTYNE 10MG TAB (BSP) LORATADINE (C) LORATADINE CLARTYNE 10'S C 13.21 1.3211 TAB 14 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
42 0012FH CLARITYNE 10MG TAB (BSP) LORATADINE LORATADINE CLARITYNE 10'S C 10.33 1.03 TAB 14 BLIS BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 0408 SECOND GENERATION ANTIHISTAMINES 2026-04-01 ORAL 0 SECOND GENERATION ANTIHISTAMINES
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
40 1303E BAYER ASPIRIN MR 325MG CAPLET (BSP/COL) ASPIR ASPIRIN BAYER ASPIRIN MR 100'S A 18.48 0.18 CAPLET 240 CPL BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 28080424 SALICYLATES 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 1306BA CARDIOASPIRIN E.C. 81MG TAB (BSP) A (C) ASPIRIN CARDIOASPIRIN E.C. 30'S C 7.34 0.2446 TAB 60 BOTT BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 28080424 SALICYLATES 2024-04-01 2026-03-31 ORAL 6 SALICYLATES
42 1306BA CARDIOASPIRIN E.C. 81MG TAB (BSP) (C) ASPIRIN CARDIOASPIRIN E.C. 30'S C 5.79 0.19 TAB 60 BOTT BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 28080424 SALICYLATES 2026-04-01 ORAL 6 SALICYLATES
40 1306BF CARDIOASPIRIN 81MG TAB (BSP/AHI) ASPIRIN CARDIOASPIRIN 30'S C 8.15 0.2717 TABLET IMMED CONT BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 28080424 SALICYLATES 2023-02-23 2024-03-31 Add to Contract as Cat A Oral 6 SALICYLATES 2023-02-23
41 1306BF CARDIOASPIRIN 81MG TAB (BSP) (C) ASPIRIN CARDIOASPIRIN 30'S C 7.34 0.2446 TAB 60 BOTT BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 28080424 SALICYLATES 2024-04-01 2026-03-31 ORAL 6 SALICYLATES
42 1306BF CARDIOASPIRIN 81MG TAB (BSP) (C) ASPIRIN CARDIOASPIRIN 30'S C 7.07 0.24 TAB 60 BOTT BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 28080424 SALICYLATES 2026-04-01 Add to Contract as Cat C ORAL 6 SALICYLATES 2026-02-11
41 2371M AFRIN 0.05% NASAL DR (BSP) OXYMETAZOLINE (C) OXYMETAZOLINE AFRIN 15ML C 13.46 13.4557 BOTT 1 BOTT BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 5232 EENT VASOCONSTRICTORS 2024-04-01 2026-03-31 NASAL 0 EENT VASOCONSTRICTORS
40 2451AN ALKA AD 2MG TAB (BSP/COL) LOPERAMIDE LOPERAMIDE ALKA AD 60'S C 17.13 0.29 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 5608 ANTIDIARRHEA AGENTS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
40 2451AP ALKA AD 2MG TAB (BSP/COL) LOPERAMIDE LOPERAMIDE ALKA AD 12'S C 3.59 0.30 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 5608 ANTIDIARRHEA AGENTS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 2451AT ALKA AD 2MG TAB (BSP) LOPERAMIDE (C) LOPERAMIDE ALKA AD 72'S C 18.35 0.2548 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 5608 ANTIDIARRHEA AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIDIARRHEA AGENTS
41 2451AV ALKA AD 2MG TAB (BSP) LOPERAMIDE (C) LOPERAMIDE ALKA 72'S C 18.35 0.2548 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 5608 ANTIDIARRHEA AGENTS 2024-04-01 2026-03-31 ORAL 6 ANTIDIARRHEA AGENTS
42 2451AV ALKA AD 2MG TAB (BSP) LOPERAMIDE LOPERAMIDE ALKA 72'S A 16.69 0.23 TAB 30 BLIS BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 5608 ANTIDIARRHEA AGENTS 2026-04-01 ORAL 6 ANTIDIARRHEA AGENTS
40 35311 NATELE CAP (BSP/AHI) MULTIVITAMINS PRENATAL MULTIVITAMINS PRENATAL NATELE 28'S C 13.97 0.50 CAPSULE 0 CAP BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2022-09-30 Oral 0 VITAMINS 2022-03-29