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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 0531V IMURAN 50MG TAB (ASG/STO) AZATHIOPRINE AZATHIOPRINE IMURAN 100'S C 174.27 1.74 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
40 0621C PURINETHOL 50MG TAB (ASG/STO) MERCAPTOPURINE MERCAPTOPURINE PURINETHOL 25'S A 104.38 4.18 TABLET 60 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
41 0621C PURINETHOL 50MG TAB (ASG) MERCAPTOP (C) MERCAPTOPURINE PURINETHOL 25'S C 107.51 4.3004 TAB 60 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2024-04-01 2026-03-31 ORAL 6 ANTINEOPLASTICS
42 0621C PURINETHOL 50MG TAB (ASG) MERCAPTOP MERCAPTOPURINE PURINETHOL 25'S C 114.79 4.59 TAB 60 BLIS ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2026-04-01 ORAL 6 ANTINEOPLASTICS
40 0692H NEOSTIGMINE 2.5MG/ML INJ (SGH/COL) NEOSTIGMINE NEOSTIGMINE 10X1ML BQ 17.13 1.71 INJECTION 0 AMP SGH SEIGFRIED-HAMELN COL COLLINS LTD 1204 PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
40 1171V ALDOMET 250MG TAB (ASG/STO) METHYLDOPA METHYLDOPA ALDOMET 30'S A 5.44 0.18 TABLET 180 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA METHYLDOPA ALDOMET 30'S A 11.63 0.3878 TAB 180 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 CENTRAL ALPHA ANTAGONIST
42 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA METHYLDOPA ALDOMET 30'S A 13.65 0.46 TAB 180 BLIS ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2026-04-01 ORAL 6 CENTRAL ALPHA ANTAGONIST
40 1172K ALDOMET 500MG TAB (ASG/STO) METHYLDOPA METHYLDOPA ALDOMET 30'S A 8.83 0.29 TABLET 180 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA METHYLDOPA ALDOMET 30'S A 19.03 0.6343 TAB 180 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2024-04-01 2026-03-31 ORAL 6 CENTRAL ALPHA ANTAGONIST
42 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA METHYLDOPA ALDOMET 30'S A 22.32 0.74 TAB 180 BLIS ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2026-04-01 ORAL 6 CENTRAL ALPHA ANTAGONIST
40 1331M FENTANYL CITRATE 50MCG/ML INJ (SGH/COL) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 13.59 1.36 INJECTION 0 AMP SGH SEIGFRIED-HAMELN COL COLLINS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
41 2791D OVESTIN 1MG VAG CR (ASG) ESTRIOL ESTRIOL OVESTIN 15G A 42 41.9981 TUBE 1 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 681604 ESTROGENS 2024-04-01 2026-03-31 Vaginal 6 ESTROGENS
42 2791D OVESTIN 1MG VAG CR (ASG) ESTRIOL ESTRIOL OVESTIN 15G A 45.80 45.80 TUBE 1 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 681604 ESTROGENS 2026-04-01 VAGINAL 6 ESTROGENS
41 27921 OVESTIN 0.5MG OV (ASG) ESTRIOL ESTRIOL OVESTIN 15'S A 41.9981 41.9981 PACK 1 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 681604 ESTROGENS 2024-04-01 2026-03-31 VAGINAL 6 ESTROGENS
42 27921 OVESTIN 0.5MG OV (ASG) ESTRIOL ESTRIOL OVESTIN 15'S A 45.80 3.05 OV 15 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 681604 ESTROGENS 2026-04-01 Amend Protocol Quantity VAGINAL 6 ESTROGENS 2026-04-23
40 3442E AMINOPHYLLINE 25MG/ML INJ (SGH/COL) AMINOPHYLLINE AMINOPHYLLINE 10X10ML B 28.00 2.80 INJECTION 0 AMP SGH SEIGFRIED-HAMELN COL COLLINS LTD 4818 RESPIRATORY SMOOTH MUSCLE RELAXANTS 2022-04-01 2024-03-31 IV 0 RESPIRATORY TRACT AGENTS
40 3571ZV ZYLOPRIM 100MG TAB (ASG/STO) ALLOPURINOL ALLOPURINOL ZYLOPRIM 50'S C 27.18 0.54 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 4040 URICOSURIC AGENTS 2022-04-01 2024-03-31 Oral 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 3571ZV ZYLOPRIM 100MG TAB (ASG) ALLOPURINOL (C) ALLOPURINOL ZYLOPRIM 50'S C 27.43 0.5486 TAB 180 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 4040 URICOSURIC AGENTS 2024-04-01 2026-03-31 ORAL 6 URICOSURIC AGENTS
40 47127 ERGOMETRINE MALEATE 500MCG/ML INJ (SGH/COL) ERGOMETRINE MALEATE ERGOMETRINE MALEATE 1ML AMP BQ 67.96 67.96 INJECTION 0 AMP SGH SEIGFRIED-HAMELN COL COLLINS LTD 7600 OXYTOCICS 2022-04-01 2024-03-31 IV 0 OXYTOCICS