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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 28321 DIAMICRON MR 60MG TAB (SER/STO) GLICLAZIDE GLICLAZIDE DIAMICRON MR 30'S A 7.18 0.24 TABLET 60 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 contract extended Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-05-27
40 2832AT DIAMICROM MR 60MG TAB (SER/COL) GLICLAZIDE GLICLAZIDE DIAMICROM MR 30'S A 7.18 0.24 TABLET 60 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Contract Extended Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-03-21
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) GLICLAZIDE GLICLAZIDE MR 30'S A 14.35 0.24 TABLET 60 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Name Change Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-05-27
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) GLICLAZIDE GLICLAZIDE MR 30'S A 7.18 0.24 TABLET 60 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD B 682020 SULPHONYLUREAS 2022-04-01 2024-03-31 Name Change Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES 2022-09-21
41 2832BP GLICLAZIDE MR 60MG TAB (SER) GLICLAZIDE GLICLAZIDE MR 30'S A 7.39 0.2465 TAB 60 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD B 682020 SULPHONYLUREAS 2024-04-01 2026-03-31 ORAL 6 SULPHONYLUREAS
41 2832BQ GLICLAZIDE MR 60MG TAB (SER) GLICLAZIDE GLICLAZIDE MR 30'S A 7.39 0.2465 TAB 60 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 682020 SULPHONYLUREAS 2024-04-01 2026-03-31 ORAL 6 SULPHONYLUREAS
40 42013 PRETERAX 0.625MG | 2.5MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42013 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42014 PRETERAX 0.625MG | 2.5MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42014 PRETERAX 0.625MG|2.5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42024 PRETERAX 2.5MG | 10MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42024 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
41 42025 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42027 PRETERAX 2.5MG | 10MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42027 PRETERAX 2.5MG|10MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42028 PRETERAX 1.5MG | 5MG TAB (SER/COL) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 42028 PRETERAX 1.25MG|5MG TAB (SER) INDAPAMIDE|PERINDOPRIL (C) INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 37.11 1.2368 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 243204 ACE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 ACE INHIBITORS
40 42029 PRETERAX 1.5MG | 5MG TAB (SER/STO) INDAPAMIDE | PERINDOPRIL INDAPAMIDE|PERINDOPRIL PRETERAX 30'S C 36.56 1.22 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 243204 ACE INHIBITORS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
40 52424 TRIVASTAL RETARD 50MG TAB (SER/STO) PIRIBEDIL PIRIBEDIL TRIVASTAL RETARD 30'S C 23.46 0.78 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 52424 TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C) PIRIBEDIL TRIVASTAL RETARD 30'S C 26.34 0.878 TAB 30 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 60 VASOACTIVE DRUGS