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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
41 3544D IN FUVITE PAED INJ (BAX) MULTIVITAMINS MULTIVITAMINS IN FUVITE PAED 5 PAIRS B 204.39 40.8782 AMP 0 BOX BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 IV 0 MULTIVITAMIN PREPARATIONS
42 3544D IN FUVITE PAED INJ (BAX) MULTIVITAMINS BIOTIN|CYANOCOBALAMIN|FOLIC ACID|NICOTINAMIDE|PYRIDOXINE|RIBOFLAVIN|THIAMINE|VIT More ... IN FUVITE PAED 5 PAIRS B 332.23 66.45 AMPG 0 BOX BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2026-04-01 2028-03-31 IV 0 MULTIVITAMIN PREPARATIONS
40 35453 INFUVITE ADULT INJ (BAX/STO) MULTIVITAMINS MULTIVITAMINS INFUVITE ADULT 5 PAIRS B 201.16 40.23 INJECTION 0 PAIR BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Price Change IV 0 VITAMINS 2022-05-11
41 35453 INFUVITE ADULT INJ (BAX) MULTIVITAMINS (B) MULTIVITAMINS INFUVITE ADULT 5 PAIRS B 201.16 40.2312 PAIR 0 BOX BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 IV 0 MULTIVITAMIN PREPARATIONS
42 35453 INFUVITE ADULT INJ (BAX) MULTIVITAMINS MULTIVITAMINS INFUVITE ADULT 5 PAIRS B 230.92 46.18 PAIR 0 BOX BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 8828 MULTIVITAMIN PREPARATIONS 2026-04-01 2028-03-31 IV 0 MULTIVITAMIN PREPARATIONS
40 35462 PEDIA POLY-VITE DROPS (BYP/PHA) MULTIVITAMINS PAEDIATRIC MULTIVITAMINS PAEDIATRIC PEDIA POLY-VITE 50ML A 10.79 10.79 DROPS 1 BOTT BYP BAYSHORE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Oral 6 VITAMINS
41 35462 PEDIA POLY-VITE DROPS (BYP) MULTIVITAMINS PAEDIATRIC MULTIVITAMINS PAEDIATRIC PEDIA POLY-VITE 50ML A 11.66 11.6616 BOTT 1 BOTT BYP BAYSHORE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS
40 35463 PEDIA POLY-VITE W | IRON DROPS (BYP/PHA) MULTIVITAMINS PAEDIATRIC WITH IRON MULTIVITAMINS PAEDIATRIC WITH IRON PEDIA POLY-VITE W|IRON 50ML A 10.79 10.79 DROPS 1 BOTT BYP BAYSHORE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 8828 MULTIVITAMIN PREPARATIONS 2022-04-01 2024-03-31 Oral 6 VITAMINS
41 35463 PEDIA POLY-VITE W|IRON DROPS (BYP) MULTIVITAMINS PAEDIATRIC MULTIVITAMINS PAEDIATRIC WITH IRON PEDIA POLY-VITE W|IRON 50ML A 11.66 11.66 BOTT 1 BOTT BYP BAYSHORE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 8828 MULTIVITAMIN PREPARATIONS 2024-04-01 2026-03-31 ORAL 6 MULTIVITAMIN PREPARATIONS 2023-09-12
40 35715 ALOPRON 100MG TAB (REM/SBI) ALLOPURINOL ALLOPURINOL ALOPRON 1000'S A 47.14 0.05 TABLET 180 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 4040 URICOSURIC AGENTS 2022-04-01 2024-03-31 Oral 6 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 35715 ALOPRON 100MG TAB (REM) ALLOPURINOL ALLOPURINOL ALOPRON 1000'S A 54.39 0.0544 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 4040 URICOSURIC AGENTS 2024-04-01 2026-03-31 ORAL 6 URICOSURIC AGENTS
42 35715 ALOPRON 100MG TAB (REM) ALLOPURINOL ALLOPURINOL ALOPRON 1000'S A 54.23 0.05 TAB 180 BOTT REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 4040 URICOSURIC AGENTS 2026-04-01 2028-03-31 ORAL 6 URICOSURIC AGENTS
41 3571AW APO-ALLOPURINOL 100MG TAB (APO) ALLOPURINOL APO-ALLOPURINOL 1000'S A 48.09 0.0481 TAB 180 BOTT APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 4040 URICOSURIC AGENTS 2024-04-01 2026-03-31 ORAL 6 URICOSURIC AGENTS
40 3571ZD APO-ALLOPURINOL 100MG TAB (APO/COL) ALLOPURINOL APO-ALLOPURINOL 1000'S A 50.29 0.05 TABLET 180 TAB APO APOTEX INC. COL COLLINS LTD 4040 URICOSURIC AGENTS 2022-04-01 2024-03-31 Oral 6 ELECTROLYTIC, CALORIC, AND WATER BALANCE
42 3571ZD APO-ALLOPURINOL 100MG TAB (APO) ALLOPURINOL APO-ALLOPURINOL 1000'S A 48.09 0.05 TAB 180 BOTT APO APOTEX INC. COL AVENTA BARBADOS 4040 URICOSURIC AGENTS 2026-04-01 2028-03-31 ORAL 6 URICOSURIC AGENTS
40 3571ZV ZYLOPRIM 100MG TAB (ASG/STO) ALLOPURINOL ALLOPURINOL ZYLOPRIM 50'S C 27.18 0.54 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 4040 URICOSURIC AGENTS 2022-04-01 2024-03-31 Oral 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 3571ZV ZYLOPRIM 100MG TAB (ASG) ALLOPURINOL (C) ALLOPURINOL ZYLOPRIM 50'S C 27.43 0.5486 TAB 180 BOX ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 4040 URICOSURIC AGENTS 2024-04-01 2026-03-31 ORAL 6 URICOSURIC AGENTS
40 3582B SODIUM BICARBONATE 8.4% INJ (BRA/COL) SODIUM BICARBONATE SODIUM BICARBONATE 100ML B 6.50 6.50 INJECTION 0 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4008 ALKALINIZING AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 3582B SODIUM BICARBONATE 8.4% INJ (BRA) (B) SODIUM BICARBONATE SODIUM BICARBONATE 100ML B 6.96 6.9589 VIAL 70 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4008 ALKALINIZING AGENTS 2024-04-01 2026-03-31 IV 0 ALKALINIZING AGENTS
42 3582B SODIUM BICARBONATE 8.4% INJ (BRA) SODIUM BICARBONATE SODIUM BICARBONATE 100ML B 9.51 9.51 VIAL 70 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4008 ALKALINIZING AGENTS 2026-04-01 2028-03-31 IV 0 ALKALINIZING AGENTS