Displaying 1 - 20 of 38
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 0072D ZOLPIDEM 10MG TAB (RYV/ALW) ZOLPIDEM ZOLPIDEM 30'S C 18.62 0.62 TABLET 0 TAB RYV RYVIS PHARMA PVT. LTD ALW ALTIMAR WHOLESALERS INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 0072D ZOLPIDEM 10MG TAB (RYV) (C) ZOLPIDEM ZOLPIDEM 30'S C 18.62 0.6207 TAB 0 BOX RYV RYVIS PHARMA PVT. LTD ALW ALTIMAR WHOLESALERS INC 282492 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 0 ANXIOLYTICS, SEDATIVES AND HYPNOTICS MISCEL
40 0093A FLUVIN 25MG/ML SUSP (RYV/ALW) GRISEOFULVIN GRISEOFULVIN FLUVIN 100ML A 12.21 0.12 SUSPENSION 500 ML RYV RYVIS PHARMA PVT. LTD ALW ALTIMAR WHOLESALERS INC 081492 ANTIFUNGALS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 ANTI-INFECTIVE AGENTS
40 0884BS SALBUTAMOL 5MG/ML RESP SOL (RYV/ATB) SALBUTAMOL SALBUTAMOL 15ML A 2.94 2.94 RESPIRATORY 20 BOTT RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 48120412 SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) 2022-04-01 2024-03-31 Nasal 6 RESPIRATORY TRACT AGENTS
40 1132GM ROSUVASTATIN 10MG TAB (RYV/ATB) ROSUVASTATIN ROSUVASTATIN 30'S A 3.91 0.13 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1133EV ATORVASTATIN 40MG TAB (RYV/ALW) ATORVASTATIN ATORVASTATIN 30'S A 2.12 0.07 TABLET 60 TAB RYV RYVIS PHARMA PVT. LTD ALW ALTIMAR WHOLESALERS INC 240608 HMG-CoA REDUCTASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1181FD BISOPROLOL 2.5MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 4.08 0.04 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2022-07-26 Oral 6 CARDIOVASCULAR DRUGS
40 1181FD BISOPROLOL 2.5MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 4.55 0.05 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-07-27 2024-03-31 Price Change Oral 6 CARDIOVASCULAR DRUGS 2022-07-26
41 1181FD BISOPROLOL 2.5MG TAB (RYV) BISOPROLOL BISOPROLOL 100'S A 5.44 0.0544 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 1182EU BISOPROLOL 5MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 4.62 0.05 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2022-07-26 Oral 6 CARDIOVASCULAR DRUGS
40 1182EU BISOPROLOL 5MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 5.15 0.05 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-07-27 2024-03-31 Price Change Oral 6 CARDIOVASCULAR DRUGS 2022-07-26
41 1182EU BISOPROLOL 5MG TAB (RYV) BISOPROLOL BISOPROLOL 100'S A 6.17 0.0617 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 1184K BISOPROLOL 10MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 7.61 0.08 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-04-01 2024-07-19 Oral 6 CARDIOVASCULAR DRUGS
40 1184K BISOPROLOL 10MG TAB (RYV/ATB) BISOPROLOL BISOPROLOL 100'S A 8.57 0.09 TABLET 30 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2022-07-20 2024-03-31 Price Change Oral 6 CARDIOVASCULAR DRUGS 2022-07-19
41 1184K BISOPROLOL 10MG TAB (RYV) BISOPROLOL BISOPROLOL 100'S A 10.87 0.1087 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD B 2424 BETA ADRENERGIC BLOCKING AGENTS 2024-04-01 2026-03-31 ORAL 6 BETA ADRENERGIC BLOCKING AGENTS
40 1431BT TRAMADOL 50MG CAP (RYV/ATB) TRAMADOL TRAMADOL 90'S A 5.30 0.06 CAPSULE 56 CAP RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 1931AM SILDENAFIL 100MG TAB (RYV) (BQ) SILDENAFIL SILDENAFIL 4'S BQ 2.64 0.6592 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS
41 1932AU ZENEGRA 50MG TAB (RYV) SILDENAFIL (BQ) SILDENAFIL ZENEGRA 4'S BQ 2.09 0.5233 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-04-01 2024-06-18 ORAL 6 PHOSPHODIESTERASE INHIBITORS 2024-06-18
41 1932AU ZENEGRA 50MG TAB (RYV) SILDENAFIL (BQ) SILDENAFIL ZENEGRA 4'S BQ 3.18 0.795 TAB 30 BOX RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 241212 PHOSPHODIESTERASE INHIBITORS 2024-06-19 2026-03-31 ORAL 6 PHOSPHODIESTERASE INHIBITORS 2024-06-19
40 2561U DIMENHYDRINATE 50MG TAB (RYV/ATB) DIMENHYDRINATE DIMENHYDRINATE 250'S A 9.92 0.04 TABLET 180 TAB RYV RYVIS PHARMA PVT. LTD ATB ANSA TRADING BARBADOS LTD 5622 ANTIEMETICS 2022-04-01 2024-03-31 Oral 6 GASTROINTESTINAL DRUGS