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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 1131AY ATORVASTATIN 10MG TAB (CPP/COL) ATORVASTATIN ATORVASTATIN 28'S A 1.06 0.04 TABLET 30 TAB CPP WOCKHARDT UK LTD COL COLLINS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1132BE ATORVASTATIN 20MG TAB (CPP/COL) ATORVASTATIN ATORVASTATIN 28'S A 1.50 0.05 TABLET 30 TAB CPP WOCKHARDT UK LTD COL COLLINS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1133AQ ATORVASTATIN 40MG TAB (CPP/COL) ATORVASTATIN ATORVASTATIN 28'S A 2.50 0.09 TABLET 60 TAB CPP WOCKHARDT UK LTD COL COLLINS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
41 1306AJ ASPIRIN GR 75MG TAB (CPP) ASPIRIN ASPIRIN GR 14x4 A 2.12 0.0379 TAB 60 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 28080424 SALICYLATES 2024-04-01 2026-03-31 ORAL 6 SALICYLATES
42 1321J CODEINE PHOSPHATE 15MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 4.00 0.14 TAB 112 BLIS CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 280808 OPIATE AGONISTS 2026-04-01 ORAL 2 OPIATE AGONISTS
42 1322M CODEINE PHOSPHATE 30MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 6.36 0.23 TAB 112 BLIS CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 280808 OPIATE AGONISTS 2026-04-01 ORAL 2 OPIATE AGONISTS
41 1322R CODEINE PHOSPHATE 30MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 3X10 A 4.4 0.1468 TAB 112 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 ORAL 2 OPIATE AGONISTS
40 21617 HYALASE 1500IU INJ (CPP/COL) HYALURONIDASE HYALURONIDASE HYALASE 1500IU BQ 42.95 42.95 INJECTION 0 AMP CPP WOCKHARDT UK LTD COL COLLINS LTD 4400 ENZYMES 2022-04-01 2024-03-31 IV 0 ENZYMES
42 2161H HYALASE 1500U INJ (CPP) HYALURONIDASE HYALURONIDASE HYALASE 10X1ML C 623.04 62.30 AMPG 0 AMP CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 4400 ENZYMES 2026-04-01 SC 0 ENZYMES
41 3362C COLCHICINE 0.5MG TAB (CPP) COLCHICINE COLCHICINE 100'S A 19.16 0.1916 TAB 90 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 4040 URICOSURIC AGENTS 2024-04-01 2026-03-31 ORAL 6 URICOSURIC AGENTS
42 3481AF FOLIC ACID 5MG TAB (CPP) FOLIC ACID FOLIC ACID 28'S A 1.30 0.05 TAB 60 BLIS CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 8808 VITAMIN B COMPLEX 2026-04-01 ORAL 6 VITAMIN B COMPLEX
41 4141AF NAPROXEN 500MG TAB (CPP) NAPROXEN NAPROXEN 28'S A 4.19 0.1495 TAB 28 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 28080492 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 6 OTHER NONSTEROIDAL ANTI-INFLAMMATORY AGENTS
41 5693AZ ACYCLOVIR 200MG TAB (CPP) ACYCLOVIR ACYCLOVIR ACYCLOVIR 25'S A 3.18 0.1272 TAB 50 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 081832 NUCLEOSIDES AND NUCLEOTIDES 2024-04-01 2026-03-31 ORAL 0 NUCLEOSIDES AND NUCLEOTIDES