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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 2511AV KONSYL ORGANIC SF PWDR (KSY/COL) PSYLLIUM PSYLLIUM KONSYL ORGANIC SF 340G C 48.93 48.93 POWDER 0 PACK KSY KONSYL PHARMACEUTICALS INC COL COLLINS LTD 5612 CATHARTICS AND LAXATIVES 2022-04-01 2024-03-31 Oral 0 GASTROINTESTINAL DRUGS
40 2511AW KONSYL DAILY SF PWDR (KSY/COL) PSYLLIUM PSYLLIUM KONSYL DAILY SF 402G A 32.86 32.86 POWDER 1 PACK KSY KONSYL PHARMACEUTICALS INC COL COLLINS LTD 5612 CATHARTICS AND LAXATIVES 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS
40 2511AX KONSYL ORIGINAL PWDR (KSY/COL) PSYLLIUM PSYLLIUM KONSYL ORIGINAL 300G A 27.18 27.18 POWDER 1 BOTT KSY KONSYL PHARMACEUTICALS INC COL COLLINS LTD 5612 CATHARTICS AND LAXATIVES 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS
41 2511AX KONSYL ORIGINAL PWDR (KSY) PSYLLIU PSYLLIUM KONSYL ORIGINAL 300G A 29.47 29.4666 BOTT 1 BOTT KSY KONSYL PHARMACEUTICALS INC COL COLLINS LTD 5612 CATHARTICS AND LAXATIVES 2024-04-01 2026-03-31 ORAL 6 CATHARTICS AND LAXATIVES
40 2511AY KONSYL DAILY PSYLLIUM FIBER PWDR (C) PSYLLIUM FIBER PWDR KONSYL DAILY PSYLLIUM FIBER PWDR 360 C $55.05 55.05 POWDER PACK KSK KONSYL PHARMACEUTICALS INC COL COLLINS LTD 5612 CATHARTICS AND LAXATIVES 0000-00-00 0000-00-00 CONTRACT AWARDED CAT C ORAL GASTROINTESTINAL DRUGS 0000-00-00
40 2511AZ KONSYL DAILY ORANGE SF PWDR (KSY) (C) PSYLLIUM FIBER PWDR KONSYL DAILY ORANGE 324'S C $44.85 $44.85 POWDER PACK KSY KONSYL PHARMACEUTICALS INC COL COLLINS LIMITED 5612 CATHARTICS AND LAXATIVES 0000-00-00 0000-00-00 CONTRACT AWARDED CAT C ORAL GASTROINTESTINAL DRUGS