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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 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 15ML C 29.66 1.98 SUSPENSION 0 ML PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHRO (C) AZITHROMYCIN ZITHROMAX 15ML C 29.96 1.9971 ML 30 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHR AZITHROMYCIN ZITHROMAX 15ML C 29.96 2.00 ML 30 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD B 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 3'S C 53.01 17.67 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY (C) AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.8413 TAB 7 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
42 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.84 TAB 10 BLIS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2026-04-01 ORAL 0 OTHER MACROLIDES
40 0211AG MERREM 500MG INJ (PFI/STO) MEROPENEM MEROPENEM MERREM 10X500MG C 561.20 56.12 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
40 0212BE MERREM 1G INJ (PFI/STO) MEROPENEM MEROPENEM MERREM 10X1G C 968.73 96.87 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
41 0212BE MERREM 1G INJ (PFI) MEROPENEM (C) MEROPENEM MERREM 10X1G C 879.6 87.9595 VIAL 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2024-04-01 2026-03-31 IV 2 CARBAPENEMS
40 04612 SALAZOPYRINE E.C. 500MG TAB (PFI/STO) SULPHAS SULPHASALAZINE SALAZOPYRINE E.C. 100'S C 70.24 0.70 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 081220 SULPHONAMIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 04612 SALAZOPYRINE E.C. 500MG TAB (PFI) SULPHA (C) SULPHASALAZINE SALAZOPYRINE E.C. 100'S C 70.95 0.7095 TAB 240 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 081220 SULPHONAMIDES 2024-04-01 2026-03-31 ORAL 6 SULPHONAMIDES
42 04612 SALAZOPYRIN 500MG TAB (PFI) SULPHASALAZINE SULPHASALAZINE SALAZOPYRIN 100'S C 70.95 0.71 TAB 240 BLIS PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 081220 SULPHONAMIDES 2026-04-01 ORAL 6 SULPHONAMIDES
40 1131CZ LIPITOR 10MG TAB (PFI/STO) ATORVASTATIN ATORVASTATIN LIPITOR 30'S C 33.19 1.11 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 1131CZ LIPITOR 10MG TAB (PFI) ATORVASTATIN (C) ATORVASTATIN LIPITOR 30'S C 33.49 1.1163 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
40 1131DA LIPITOR 10MG TAB (PFI/SBI) ATORVASTATIN ATORVASTATIN LIPITOR 30'S C 33.19 1.11 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 1131DA LIPITOR 10MG TAB (PFI) ATORVASTATIN (C) ATORVASTATIN LIPITOR 30'S C 33.49 1.1163 TAB 30 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
42 1131GX LIPITOR 10MG TAB (PFI) ATORVASTATI (C) ATORVASTATIN LIPITOR 3X10 C 33.49 1.12 TAB 30 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 240608 HMG-CoA REDUCTASE INHIBITORS 2026-04-01 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
40 1132DV LIPITOR 20MG TAB (PFI/STO) ATORVASTATIN ATORVASTATIN LIPITOR 30'S C 36.21 1.21 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 1132DV LIPITOR 20MG TAB (PFI) ATORVASTATIN (C) ATORVASTATIN LIPITOR 30'S C 36.53 1.2178 TAB 30 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 HMG-CoA REDUCTASE INHIBITORS
40 1132DW LIPITOR 20MG TAB (PFI/SBI) ATORVASTATIN ATORVASTATIN LIPITOR 30'S C 36.21 1.21 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS