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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 0114BP ALTACEF 250MG TAB (GLP/ATB) CEFUROXIME CEFUROXIME ALTACEF 10'S BQ $4.08 $0.41 TABLET 0 TAB GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 08120608 SECOND GEN CEPHALOSPORINS 2022-04-01 2024-03-31 Change Local Agent Oral 6 ANTI-INFECTIVE AGENTS 2022-03-22
40 0114L ZINNAT 250MG TAB (GSK/COL) CEFUROXIME CEFUROXIME ZINNAT 50'S C $97.07 $1.94 TABLET 0 TAB GSK GLAXOSMITHKLINE COL COLLINS LTD 08120608 SECOND GEN CEPHALOSPORINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 01243 OPTOMYCIN 0.5% EYE DR (ASL/PHA) CHLORAMPHENIC CHLORAMPHENICOL OPTOMYCIN 10ML C $4.08 $4.08 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0124N CHLORAMPHENICOL 0.5% EYE DR (MTP/COL) CHLORAMPHENICOL CHLORAMPHENICOL 10ML C $2.58 $2.58 EYE DROP 0 BOTT MTP MARTINDALE PHARMACEUTICALS COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0124R CHLORAMPHENICOL 0.5% EYE DR (CIR/AHI) CHLORAMPHENICOL CHLORAMPHENICOL 10ML A $1.90 $1.90 EYE DROP 1 BOTT CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0124V CHLORAMPHENICOL 0.5% EYE DR (FSB/ATB) CHLORAMPHENICOL CHLORAMPHENICOL 10ML A $1.60 $1.60 EYE DROP 1 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0125J CHLORAMPHENICOL 1% EYE OINT (MTP/COL) CHLORAMPHENICOL CHLORAMPHENICOL 4G A $4.21 $4.21 EYE OINTMENT 1 TUBE MTP MARTINDALE PHARMACEUTICALS COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0125M OPTICHLOR SL 1% EYE OINTMENT CHLORAMPHENICOL OPTICHLOR SL 1% 5G A $4.35 1 OINT SPC PSB PHARMACEUTICAL SOLUTIONS 520404 EENT ANTIBACTERIALS 2023-06-01 2024-03-31 EYE 0 EENT INFECTIVES 2023-06-09
40 01261 CHLORAMPHENICOL MINIMS 0.5% EYE DR (CAM/STO) CHLORAMPHENICOL CHLORAMPHENICOL MINIMS 20X0.5ML BQ $94.73 $4.74 EYE DROP 0 AMP CAM MORNINGSIDE PHARMACEUTICALS STO BRYDEN STOKES LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 Ophthalmic 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0131AE AZITHROMYCIN MK 40MG/ML SUSP (BON/COL) AZITHROMYCIN AZITHROMYCIN MK 15ML A $5.30 $0.35 SUSPENSION 30 ML BON CORPORACION BONIMA COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131AF CLARITHROMYCIN MK 50MG/ML SUSP (BON/COL) CLARITHROMYCIN CLARITHROMYCIN MK 60ML A $14.27 $0.24 SUSPENSION 60 ML BON CORPORACION BONIMA COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131AH CLARITHROMYCIN MK 25MG/ML SUSP (BON/COL) CLARITHROMYCIN CLARITHROMYCIN MK 60ML A $9.38 $0.16 SUSPENSION 100 ML BON CORPORACION BONIMA COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131AL ERYTHROMYCIN 50MG/ML SUSP (BON/COL) ERYTHROMY ERYTHROMYCIN ESTOLATE ERYTHROMYCIN 60ML A $7.75 $0.13 SUSPENSION 300 ML BON CORPORACION BONIMA COL COLLINS LTD 08121204 ERYTHROMYCINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131BE SKAZI 40MG/ML SUSP (SKH/RXP) AZITHROMYCIN AZITHROMYCIN SKAZI 15ML A $4.89 $0.33 SUSPENSION 30 ML SKH S. KANT HEALTHCARE LTD RXP RX PRO INC 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131CW AZITHROMYCIN 40MG/ML SUSP (KWA/ATB) AZITHROMYCIN AZITHROMYCIN 15ML A $4.76 $0.32 SUSPENSION 30 ML KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 08121292 OTHER MACROLIDES 2022-04-01 2022-09-30 Oral 0 ANTI-INFECTIVE AGENTS 2022-03-30
40 0131CX BINOZYT 40MG/ML SUSP (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 30ML C $20.12 $0.67 SUSPENSION 0 ML BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID 60ML C $15.79 $0.26 SUSPENSION 0 ML ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID 60ML C $15.79 $0.26 SUSPENSION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8121292 OTHER MACROLIDES 2022-04-01 2023-03-31 Delete from contract Oral 0 OTHER MACROLIDES 2023-03-02
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID 60ML C $11.50 $0.19 SUSPENSION 0 ML ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID 60ML C $11.50 $0.19 SUSPENSION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8121292 OTHER MACROLIDES 2022-04-01 2023-03-31 Delete from contract Oral 0 OTHER MACROLIDES 2023-03-02