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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 2961K NORCOLUT 5MG TAB (CHW/AHI) NORETHISTERONE NORETHISTERONE NORCOLUT 2X10 A 3.21 0.16 TABLET 90 TAB CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6832 PROGESTINS 2022-04-01 2022-09-30 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-03-29
41 2961K NORCOLUT 5MG TAB (CHW) NORETHISTERONE (C) NORETHISTERONE NORCOLUT 2X10 C 3.45 0.1726 TAB 90 BOX CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6832 PROGESTINS 2024-04-01 2026-03-31 ORAL 6 PROGESTINS
41 29628 POSTINOR 750MCG TAB (CHW) LEVONORGESTREL (C) LEVONORGESTREL POSTINOR 2'S C 2.66 1.332 TAB 2 BOX CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2024-04-01 2026-03-31 ORAL 0 CONTRACEPTIVES
42 29628 POSTINOR 750MCG TAB (CHW) LEVONORGESTREL LEVONORGESTREL POSTINOR 2'S C 3.53 1.77 TAB 2 BLIS CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2026-04-01 ORAL 0 CONTRACEPTIVES
40 2962A POSTINOR SD 1.5MG TAB (CHW/AHI) LEVONORGESTRE LEVONORGESTREL POSTINOR SD 1'S C 12.23 12.23 TABLET 0 TAB CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2022-04-01 2022-09-30 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES 2022-03-29
41 2962A POSTINOR SD 1.5MG TAB (CHW) LEVONORGESTR (C) LEVONORGESTREL POSTINOR SD 1'S C 4.38 4.3765 TAB 1 BOX CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2024-04-01 2026-03-31 ORAL 0 CONTRACEPTIVES
42 2962A POSTINOR SD 1.5MG TAB (CHW) LEVONORGESTR LEVONORGESTREL POSTINOR SD 1'S C 4.76 4.76 TAB 1 BLIS CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2026-04-01 ORAL 0 CONTRACEPTIVES
42 60717 KLION D 100MG|100MG VAG OV (CHW) METRONI METRONIDAZOLE|MICONAZOLE KLION D 10'S A 11.15 11.15 PACK 1 BLIS CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 081492 ANTIFUNGALS, MISCELLANEOUS 2026-04-01 VAGINAL 0 ANTIFUNGALS, MISCELLANEOUS
41 7621BV LINDYNETTE 20MCG|75MCG TAB (CHW) ETHINYL ESTRADIOL|GESTODENE (C) ETHINYL ESTRADIOL|GESTODENE LINDYNETTE 21'S C 4.1 4.1047 PACK 0 BOX CHW CHEMICAL WORKS OF GEDEON RICHTER LTD AHI ARMSTRONG HEALTHCARE INC 6812 CONTRACEPTIVES 2024-04-01 2026-03-31 ORAL 0 CONTRACEPTIVES