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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 13028 ASPIRIN DISPERSIBLE 300MG TAB (ACD/AHI) ASPIRIN ASPIRIN DISPERSIBLE 32'S A 8.15 0.25 TABLET 30 TAB ACD ACCORD AHI ARMSTRONG HEALTHCARE INC 28080424 SALICYLATES 2022-04-01 2024-03-31 Add to Contract as Cat A Oral 6 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-11
40 25611 GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINAT DIMENHYDRINATE GRAVOL 100'S C 24.82 0.25 TABLET 0 TAB CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 25611 GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) DIMENHYDRINATE GRAVOL 100'S C 27.54 0.2754 TAB 180 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2026-03-31 ORAL 6 ANTIEMETICS
42 25611 GRAVOL 50MG TAB (CDC) DIMENHYDRINAT DIMENHYDRINATE GRAVOL 100'S C 29.03 0.29 TAB 180 BLIS CDC CHURCH & DWIGHT CANADA CORP COL AVENTA BARBADOS 5622 ANTIEMETICS 2026-04-01 ORAL 6 ANTIEMETICS
40 25619 GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINATE DIMENHYDRINATE GRAVOL 30'S C 7.34 0.24 TABLET 0 TAB CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 25619 GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) DIMENHYDRINATE GRAVOL 30'S C 7.53 0.251 TAB 180 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2026-03-31 ORAL 6 ANTIEMETICS
40 2561B GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINATE DIMENHYDRINATE GRAVOL 10'S C 3.43 0.34 TABLET 0 TAB CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 2561B GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) DIMENHYDRINATE GRAVOL 10'S C 3.72 0.3724 TAB 180 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2026-03-31 ORAL 6 ANTIEMETICS
42 2561B GRAVOL 50MG TAB (CDC) DIMENHYDRINAT DIMENHYDRINATE GRAVOL 10'S C 4.05 0.41 TAB 180 BLIS CDC CHURCH & DWIGHT CANADA CORP COL AVENTA BARBADOS 5622 ANTIEMETICS 2026-04-01 ORAL 6 ANTIEMETICS
40 25628 GRAVOL KIDS 3MG/ML SYR (CDC/COL) DIMENHYDRINATE DIMENHYDRINATE GRAVOL KIDS 75ML C 5.95 0.08 SYRUP 0 ML CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
41 25628 GRAVOL KIDS 3MG/ML SYR (CDC) DIMENHYDRINATE (C) DIMENHYDRINATE GRAVOL KIDS 75ML C 6.44 0.0859 ML 125 BOTT CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2026-03-31 ORAL 6 ANTIEMETICS
42 25628 GRAVOL KIDS 3MG/ML SYR (CDC) DIMENHYDRINATE DIMENHYDRINATE GRAVOL KIDS 75ML C 6.74 0.09 ML 125 BOTT CDC CHURCH & DWIGHT CANADA CORP COL AVENTA BARBADOS 5622 ANTIEMETICS 2026-04-01 ORAL 6 ANTIEMETICS
40 25633 GRAVOL 100MG SUPPOS (CDC/COL) DIMENHYDRINATE DIMENHYDRINATE GRAVOL 10'S A 8.97 0.90 SUPPOSITORY 10 SUPP CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 RECTAL 6 GASTROINTESTINAL DRUGS
41 25633 GRAVOL 100MG SUPPOS (CDC) DIMENHYDRINATE DIMENHYDRINATE GRAVOL 10'S A 9.81 0.9813 SUPP 10 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2026-03-31 RECTAL 6 ANTIEMETICS
42 25633 GRAVOL 100MG SUPPOS (CDC) DIMENHYDRINATE DIMENHYDRINATE GRAVOL 10'S A 10.55 1.06 SUPP 10 BOX CDC CHURCH & DWIGHT CANADA CORP COL AVENTA BARBADOS 5622 ANTIEMETICS 2026-04-01 RECTAL 6 ANTIEMETICS
40 25643 GRAVOL INFANT 25MG SUPPOS (CDC/COL) DIMENHYDR DIMENHYDRINATE GRAVOL INFANT 10'S A 7.94 0.79 SUPPOSITORY 10 SUPP CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 RECTAL 0 GASTROINTESTINAL DRUGS
41 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD DIMENHYDRINATE GRAVOL INFANT 10'S A 10.38 1.0384 SUPP 10 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-04-01 2024-12-03 RECTAL 0 ANTIEMETICS 2024-12-03
41 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD DIMENHYDRINATE GRAVOL INFANT 10'S A 13.8 1.38 SUPP 10 BOX CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2024-12-04 2026-03-31 RECTAL 0 ANTIEMETICS 2024-12-04
42 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD DIMENHYDRINATE GRAVOL INFANT 10'S A 15.55 1.56 SUPP 10 BOX CDC CHURCH & DWIGHT CANADA CORP COL AVENTA BARBADOS 5622 ANTIEMETICS 2026-04-01 RECTAL 0 ANTIEMETICS
40 25671 GRAVOL DUAL RELIEF 100MG CAP (CDC/COL) DIMENH DIMENHYDRINATE GRAVOL DUAL RELIEF 24'S C 12.42 0.52 CAPSULE 0 CAP CDC CHURCH & DWIGHT CANADA CORP COL COLLINS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS