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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
42 4352A BOTTLE, GLASS RX, 60ML AMBER (BEA) BOTTLES BOTTLES BOTTLE, GLASS RX, 60ML AMBER 81'S B 32.29 0.40 EACH 0 BOX BEA BEATSON CLARKE & CO. LTD., COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 43536 BOTTLE, GLASS RX, 100ML FLAT (BEA/COL) BOT BOTTLES BOTTLE, GLASS RX, 100ML FLAT 90'S B 87.45 0.97 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 Price Change 0 MEDICAL DEVICES 2022-05-09
41 43536 BOTTLE, GLASS RX, 100ML FLAT (BEA) BOTTLES BOTTLE, GLASS RX, 100ML FLAT 90'S B 75.46 0.8385 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
42 43536 BOTTLE, GLASS RX, 100ML FLAT (BEA) BOTTLES BOTTLE, GLASS RX, 100ML FLAT 90'S B 95.14 1.06 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 43539 BOTTLE, GLASS RX, 100ML AMBER (BEA/COL) BOT BOTTLES BOTTLE, GLASS RX, 100ML AMBER 104'S B 42.76 0.41 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
40 43544 BOTTLE, GLASS RX, 200ML AMBER (BEA/COL) BOT BOTTLES BOTTLE, GLASS RX, 200ML AMBER 67'S B 37.68 0.56 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
40 43545 BOTTLE, GLASS RX, 200ML FLAT (BEA/COL) BOTT BOTTLES BOTTLE, GLASS RX, 200ML FLAT 56'S B 37.78 0.67 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
41 43545 BOTTLE, GLASS RX, 200ML FLAT (BEA) (B) BOTTLES BOTTLE, GLASS RX, 200ML FLAT 56'S B 33.57 0.5995 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
41 43547 BOTTLE, GLASS RX, 200ML, AMBER 200ML (BEA) (B) BOTTLES BOTTLE, GLASS RX, 200ML, AMBER 64'S B 54.83 0.8567 EACH 0 BOTT BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
42 43547 BOTTLE, GLASS RX, 200ML, AMBER 200ML (BEA) BOTTLES BOTTLE, GLASS RX, 200ML, AMBER 64'S B 49.91 0.78 EACH 0 BOX BEA BEATSON CLARKE & CO. LTD., COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 43554 BOTTLE, GLASS RX, 500ML AMBER (BEA/COL) BOTTLES BOTTLE, GLASS RX, 500ML AMBER 35'S B 30.04 0.86 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
42 43555 BOTTLE, GLASS RX, 500ML AMBER (BEA) BOTTLES BOTTLE, GLASS RX, 500ML AMBER 25'S B 36.02 1.44 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 43574 BOTTLE, GLASS RX, 150ML AMBER (BEA/COL) BOT BOTTLES BOTTLE, GLASS RX, 150ML AMBER 84'S B 42.19 0.50 0 EACH BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 Price Change 0 MEDICAL DEVICES 2022-05-09
41 43574 BOTTLE, GLASS RX, 150ML AMBER (BEA) BOTTLES BOTTLE, GLASS RX, 150ML AMBER 84'S B 41.97 0.4997 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2024-04-01 2025-01-28 0 MEDICAL DEVICES 2024-12-17
41 43579 BOTTLES, GLASS RX, 150ML AMBER (BEA) BOTTLES BOTTLES, GLASS RX, 150ML AMBER 81'S B 40.48 0.4998 EACH 4 BOX BEA BEATSON CLARKE & CO. LTD., COL COLLINS LTD 9400 MEDICAL DEVICES 2024-12-17 2026-03-31 MEDICAL DEVICES 2024-12-17
42 43579 BOTTLES, GLASS RX, 150ML AMBER AEROSOL (BEA) BOTTLES BOTTLES, GLASS RX, 150ML AMBER 81'S B 40.50 0.50 EACH 0 BOX BEA BEATSON CLARKE & CO. LTD., COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 43616 INTRAFIX PRIMELINE (4062181/46 SET (BRA/COL) ADMIN SET ADULT INTRAFIX PRIMELINE (4062181|46 SET B 1.25 1.25 SET 0 SET BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
41 43616 INTRAFIX PRIMELINE (4062181/46 SET (BRA (B) ADMIN SET ADULT INTRAFIX PRIMELINE (4062181|46 SET B 1.82 1.8213 SET 10 BAG BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
42 43616 INTRAFIX PRIMELINE (4062181/46 SET (BRA ADMIN SET ADULT INTRAFIX PRIMELINE (4062181|46 SET B 1.69 1.69 SET 10 BAG BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 4361AA BURETROL SOLUTION SET (BAX/STO) ADMIN SET AD ADMIN SET ADULT BURETROL SOLUTION SET B 2.58 2.58 SET 0 SET BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES