Displaying 1 - 15 of 15
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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
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
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
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
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
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
41 5083D SOSTENON 250MG/ML INJ (ASG) TESTOSTERONE (BQ) TESTOSTERONE SOSTENON 250MG PFS BQ 34.17 34.1693 PFS 4 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 6808 ANDROGENS 2024-04-01 2026-03-31 IM 6 ANDROGENS
40 6302AQ NIMBEX 2MG/ML INJ (ASG/STO) CISATRACURIUM CISATRACURIUM NIMBEX 5X5ML BQ 114.17 22.83 INJECTION 0 VIAL ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 6302AQ NIMBEX 2MG/ML INJ (ASG) CISATRACURI (BQ) CISATRACURIUM NIMBEX 5X5ML BQ 114.17 22.8339 VIAL 0 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2024-04-01 2026-03-31 IV 0 NEUROMUSCULAR BLOCKING AGENTS
41 66311 DIPRIVAN 10MG/ML INJ (ASG) PROPOFOL (C) PROPOFOL DIPRIVAN 5X20ML C 73.91 14.7822 AMP 30 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 2804 GENERAL ANESTHETICS 2024-04-01 2026-03-31 IV 0 GENERAL ANESTHETICS