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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 1306BT ASPIRIN 81MG TAB (HEA) ASPIRIN ASPIRIN 1000'S A 33.63 0.03 TAB 60 BLIS HEA HEALTH 2000 INC CWS CAPSULE WHOLESALE 28080424 SALICYLATES 2026-04-01 Add to Contract as Cat A ORAL 6 SALICYLATES 2026-01-26
42 1306BU ASPIRIN EC 81MG TAB (HEA) ASPIRIN ASPIRIN EC 100X10 A 33.63 0.03 TAB 60 HEA HEALTH 2000 INC STO BRYDEN STOKES LTD 28080424 SALICYLATES 2026-04-01 Add to Contract as Cat A ORAL 6 SALICYLATES 2026-02-27
40 1321G CODEINE PHOSPHATE 15MG TAB (TEV/COL) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 5.03 0.18 TABLET 112 TAB TEV TEVA UK LTD. COL COLLINS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 Oral 2 CENTRAL NERVOUS SYSTEM DRUGS
41 1321G CODEINE PHOSPHATE 15MG TAB (TEV) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 4.7 0.168 TAB 112 BOX TEV TEVA UK LTD. COL COLLINS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 ORAL 2 OPIATE AGONISTS
42 1321J CODEINE PHOSPHATE 15MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 4.00 0.14 TAB 112 BLIS CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 280808 OPIATE AGONISTS 2026-04-01 ORAL 2 OPIATE AGONISTS
40 1322L CODEINE PHOSPHATE 30MG TAB (TEV/COL) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 6.85 0.24 TABLET 112 TAB TEV TEVA UK LTD. COL COLLINS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 Oral 2 CENTRAL NERVOUS SYSTEM DRUGS
41 1322L CODEINE PHOSPHATE 30MG TAB (TEV) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 5.76 0.2058 TAB 112 BOX TEV TEVA UK LTD. COL COLLINS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 ORAL 2 OPIATE AGONISTS
42 1322M CODEINE PHOSPHATE 30MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 28'S A 6.36 0.23 TAB 112 BLIS CPP WOCKHARDT UK LTD COL AVENTA BARBADOS 280808 OPIATE AGONISTS 2026-04-01 ORAL 2 OPIATE AGONISTS
41 1322R CODEINE PHOSPHATE 30MG TAB (CPP) CODEINE PHOSPHATE CODEINE PHOSPHATE 3X10 A 4.4 0.1468 TAB 112 BOX CPP WOCKHARDT UK LTD COL COLLINS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 ORAL 2 OPIATE AGONISTS
40 13235 CODEINE PHOSPHATE 30MG/ML INJ (KWA/ATB) CODEINE PHOSPHATE CODEINE PHOSPHATE 10X1ML C 203.87 20.39 INJECTION 0 AMP KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
41 13235 CODEINE PHOSPHATE 30MG/ML INJ (KWA) CODEINE PHOSPHATE CODEINE PHOSPHATE 10X1ML C 135.59 13.559 AMP 0 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 2808 ANALGESICS-ANTIPYRETICS 2024-04-01 2026-03-31 IV 0 ANALGESICS-ANTIPYRETICS
41 13315 FENTANYL CITRATE 50MCG/ML INJ (RTM) (BQ) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 24.85 2.4846 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 IV 0 OPIATE AGONISTS
42 13315 FENTANYL CITRATE 50MCG/ML INJ (RTM) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 14.95 1.50 AMPG 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280808 OPIATE AGONISTS 2026-04-01 IV 0 OPIATE AGONISTS
40 13319 FENTANYL CITRATE 50MCG/ML INJ (MTP/COL) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 13.05 1.31 INJECTION 0 AMP MTP MARTINDALE PHARMACEUTICALS COL COLLINS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
41 13319 FENTANYL CITRATE 50MCG/ML INJ (MTP) (BQ) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 17.94 1.7941 AMP 0 BOX MTP MARTINDALE PHARMACEUTICALS COL COLLINS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 IV 0 OPIATE AGONISTS
40 1331K FENTANYL CITRATE 50MCG/ML INJ (KWA/ATB) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 25.17 0.25 INJECTION 0 AMP KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 280808 OPIATE AGONISTS 2022-04-01 2022-09-30 IV 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-30
41 1331K FENTANYL CITRATE 50MCG/ML INJ (KWA) (BQ) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 18.02 1.8022 AMP 0 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 IV 0 OPIATE AGONISTS
40 1331M FENTANYL CITRATE 50MCG/ML INJ (SGH/COL) FENTANYL CITRATE FENTANYL CITRATE 10X2ML BQ 13.59 1.36 INJECTION 0 AMP SGH SEIGFRIED-HAMELN COL COLLINS LTD 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
40 13325 FENTANYL CITRATE 50MCG/ML INJ (RTM/PHA) FENTANYL CITRATE FENTANYL CITRATE 10X10ML BQ 27.37 2.74 INJECTION 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280808 OPIATE AGONISTS 2022-04-01 2024-03-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
41 13325 FENTANYL CITRATE 50MCG/ML INJ (RTM) (BQ) FENTANYL CITRATE FENTANYL CITRATE 10X10ML BQ 38.22 3.822 VIAL 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280808 OPIATE AGONISTS 2024-04-01 2026-03-31 IV 0 OPIATE AGONISTS