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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 0742X BENZTROPINE 1MG/ML INJ (CIR/AHI) BENZTROPINE BENZTROPINE 2ML B 5.11 5.11 INJECTION 0 AMP CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 283608 ANTICHOLINERGIC AGENTS (PARKINSONS) 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
42 0742Y BENZTROPINE 1MG/ML INJ (KWA) BENZTROPINE BENZTROPINE 10X2ML B 23.54 2.35 VIAL 6 KWA KWALITY PHARMACEUTICALS STO BRYDEN STOKES LTD 283608 ANTICHOLINERGIC AGENTS (PARKINSONS) 2026-04-01 Add to Contract as Cat B IV/IM 6 ANTICHOLINERGIC AGENTS (PARKINSONS) 2026-03-02
40 07515 DIVIDOL 10MG TAB (REM/SBI) HYOSCINE BUTYLBROM HYOSCINE BUTYLBROMIDE DIVIDOL 100'S A 12.23 0.12 TABLET 120 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 07515 DIVIDOL 10MG TAB (REM) HYOSCINE BUTYLBRO HYOSCINE BUTYLBROMIDE DIVIDOL 100'S A 10.38 0.1038 TAB 120 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2024-04-01 2026-03-31 ORAL 0 ANTIMUSCARINICS/ANTISPASMODICS
42 07515 DIVIDOL 10MG TAB (REM) HYOSCINE BUTYLBRO HYOSCINE BUTYLBROMIDE DIVIDOL 100'S A 10.33 0.10 TAB 120 BLIS REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2026-04-01 ORAL 0 ANTIMUSCARINICS/ANTISPASMODICS
40 0751J HYOSCINE BUTYLBROMIDE 10MG TAB (KWA/ATB) HYOSCINE BUTYLBROMIDE HYOSCINE BUTYLBROMIDE 10X10 A 20.80 0.21 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2022-09-30 Oral 0 AUTONOMIC DRUGS 2022-03-30
40 0751N BUSCOPAN 10MG TAB (SFA/COL) HYOSCINE BUTYLBRO HYOSCINE BUTYLBROMIDE BUSCOPAN 100'S C 32.62 0.33 TABLET 0 TAB SFA SANOFI AVENTIS COL COLLINS LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 0751Q HYOSCINE BUTYLBROMIDE 10MG TAB (MPI) HYOSCINE BUTYLBROMIDE HYOSCINE 100'S A 11.44 0.1144 TAB 120 BOTT MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 120808 ANTIMUSCARINICS/ANTISPASMODICS 2024-04-01 2026-03-31 ORAL 0 ANTIMUSCARINICS/ANTISPASMODICS
40 0752F BUTYLSCOPOLAMINE 20MG/ML INJ (RTM/PHA) HYOSCINE BUTYLBROMIDE HYOSCINE BUTYLBROMIDE BUTYLSCOPOLAMINE 10X1ML B 18.92 1.89 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0752F BUTYLSCOPOLAMINE 20MG/ML INJ (RTM) HYOSCINE BUTYLBROMIDE (B) HYOSCINE BUTYLBROMIDE BUTYLSCOPOLAMINE 10X1ML B 19.33 1.9327 AMP 20 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 120808 ANTIMUSCARINICS/ANTISPASMODICS 2024-04-01 2026-03-31 IV 0 ANTIMUSCARINICS/ANTISPASMODICS
42 0752F BUTYLSCOPOLAMINE 20MG/ML INJ (RTM) HYOSCINE BUTYLBROMIDE HYOSCINE BUTYLBROMIDE BUTYLSCOPOLAMINE 10X1ML B 13.86 1.39 AMPG 20 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 120808 ANTIMUSCARINICS/ANTISPASMODICS 2026-04-01 IV 0 ANTIMUSCARINICS/ANTISPASMODICS
40 0752K HYOSCINE BUTYLBROMIDE 20MG/ML INJ (MON/PHA) HYOSCINE BUTYLBROMIDE HYOSCINE BUTYLBROMIDE 10X1ML B 16.26 1.63 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
40 0752L BUSCOPAN 20MG/ML INJ (SFA/COL) HYOSCINE BUTYL HYOSCINE BUTYLBROMIDE BUSCOPAN 10X1ML C 20.39 2.04 INJECTION 0 AMP SFA SANOFI AVENTIS COL COLLINS LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
40 0752L BUSCOPAN 20MG/ML INJ (SFA/COL) HYOSCINE BUTYL (C) HYOSCINE BUTYLBROMIDE BUSCOPAN 10X1ML C 26.37 2.637 INJECTION SFA SANOFI AVENTIS COL COLLINS LTD 1208 ANTICHOLINERGIC AGENTS 2022-12-10 2024-03-31 Price Change IV 0 ANTICHOLINERGIC AGENTS 2022-12-09
41 0752M HYOSCINE BUTYLBROMIDE 20MG/ML INJ (FSB) (B) HYOSCINE BUTYLBROMIDE HYOSCINE BUTYLBROMIDE 10X1ML B 10.66 1.0656 AMP 20 BOX FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2024-04-01 2026-03-31 IV/IM 0 ANTIMUSCARINICS/ANTISPASMODICS
40 07918 ADRENALINE 1MG/ML IV/IM INJ (RTM/PHA) ADRENALINE ADRENALINE 10X1ML B 35.01 3.50 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-06-01 2024-03-31 Price Change IV/IM 0 AUTONOMIC DRUGS 2022-05-31
40 07918A ADRENALINE 1MG/ML IV/IM INJ (RTM/PHA) ADRENALINE ADRENALINE 10X1ML B 24.14 2.41 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2022-05-31 IV/IM 0 AUTONOMIC DRUGS
42 0791AD ADREFORD 1MG/ML IV/IM INJ (JLP) ADRENALINE ADRENALINE ADREFORD 100X1ML B 32.62 0.33 AMPG 60 AMP JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2026-04-01 IV/IM 0 ALPHA & BETA ADRENERGIC AGONIST
40 0791AF ADRENALINE 1MG/ML IV/IM INJ (MON/PHA) ADRENALINE ADRENALINE 10X1ML B 7.07 0.71 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV/IM 0 AUTONOMIC DRUGS
42 0791AF ADRENALINE 1MG/ML IV/IM INJ (MON) ADRENALINE ADRENALINE 10X1ML B 7.75 0.78 AMPG 60 BOX MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2026-04-01 IV/IM 0 ALPHA & BETA ADRENERGIC AGONIST