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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 0131DT SKAZI 40MG/ML SUSP (SKH) AZITHROMYCIN SKAZI 40MG /ML SUSP 15ML A $4.89 SUSPENSION 30 SKH S KANT HEALTHCARE ATB ANSA TRADING BARBADOS LIMITED 08121292 0 0000-00-00
40 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 15ML C $29.66 $1.98 SUSPENSION 0 ML PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 3'S C $53.01 $17.67 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141DA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 3'S C $8.64 $2.88 TABLET 0 TAB BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141FU KLARICID XL 500MG TAB (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID XL 10'S C $16.66 $1.67 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141FU KLARICID XL 500MG TAB (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID XL 10'S C $16.66 $1.67 TABLET IMMED 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 0141FV KLARICID 500MG TAB (ABB/PHA) CLARITHROMYCIN CLARITHROMYCIN KLARICID 10'S C $16.72 $1.67 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Price Change Oral 0 ANTI-INFECTIVE AGENTS 2022-05-05
40 0141GA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN AZITHROMYCIN BINOZYT 12'S C $31.48 $2.62 TABLET 0 TAB BCH SANDOZ COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141GB EZECURE 500MG TAB (EMC/COL) AZITHROMYCIN AZITHROMYCIN EZECURE 3'S A $1.39 $0.46 TABLET 7 TAB EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141GC AAP-ERYTHROMYCIN 250MG TAB (APO/COL) ERYTHROMYCIN BASE ERYTHROMYCIN BASE AAP-ERYTHROMYCIN 100'S A $33.60 $0.34 TABLET 56 TAB APO APOTEX INC. COL COLLINS LTD 08121204 ERYTHROMYCINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141GX AZITHROMYCIN 500MG TAB (FSB/ATB) AZITHROMYCIN AZITHROMYCIN 30'S A $13.65 $0.46 TABLET 7 TAB FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Add to Contract as Cat A oral 0 ANTI-INFECTIVE AGENTS 2022-03-21
40 0141GZ AZITHROMYCIN 500MG TAB (FSB/ATB) AZITHROMYCIN AZITHROMYCIN 100'S A $43.68 $0.44 TABLET 7 TAB FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 08121292 OTHER MACROLIDES 2022-04-19 2024-03-31 Add to Contract as Cat A oral 0 ANTI-INFECTIVE AGENTS 2022-04-19
40 0141HA EZECURE 500MG TAB (EMC/COL) AZITHROMYCIN AZITHROMYCIN EZECURE 60'S A $27.80 $0.46 TABLET 7 TAB EMC EMCURE PHARMACEUTICALS LTD COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-08-10 2024-03-31 Package Size Change oral 0 ANTI-INFECTIVE AGENTS 2022-08-10
40 0141M CLAREM 250MG TAB (REM/SBI) CLARITHROMYCIN CLARITHROMYCIN CLAREM 100'S A $7.99 $0.08 TABLET 14 TAB REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141ZK APO-CLARITHROMYCIN 500MG TAB (APO/COL) CLARITHROMYCIN APO-CLARITHROMYCIN 100'S A $76.30 $0.76 TABLET 14 TAB APO APOTEX INC. COL COLLINS LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0142B ERYTHROMYCIN 5% EYE OINT (AKI/AHI) ERYTHROMYCIN ERYTHROMYCIN 3.5G C $67.31 $67.31 EYE OINTMENT 0 TUBE AKI AKORN INC. AHI ARMSTRONG HEALTHCARE INC 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0152BF AMOXIL 25MG/ML SUSP (GSK/COL) AMOXICILLIN AMOXICILLIN AMOXIL 100ML C $11.47 $0.11 SUSPENSION 0 ML GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0152BQ AMOXICILLIN 25MG/ML SUSP (MCP/AHI) AMOXICILLIN AMOXICILLIN 100ML A $1.79 $0.02 SUSPENSION 300 ML MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0153C AMOXAPEN 500MG CAP (REM/SBI) AMOXICILLIN AMOXICILLIN AMOXAPEN 100x10 C $115.83 $0.12 CAPSULE 0 CAP REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0153CC AMOXIL 500MG CAP (GSK/COL) AMOXICILLIN AMOXICILLIN AMOXIL 100'S C $42.41 $0.42 CAPSULE 0 CAP GSK GLAXOSMITHKLINE COL COLLINS LTD 081216 PENICILLINS 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS