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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
41 20567 DEXTROSE 10% (CSC) PLASTIC BAG (B) DEXTROSE DEXTROSE 500ML B 2.5 2.5009 BAG 50 BAG CSC FORSURE MEDICAL PHA PHARMACY SALES CARIBBEAN 4020 CALORIC AGENTS 2024-04-01 2026-03-31 INJ 0 CALORIC AGENTS
40 2056D DEXTROSE (2B0163Q) 10% (BAX/STO) DEXTROSE DEXTROSE (2B0163Q) 500ML B 3.34 3.34 INJECTION 0 BOTT BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 2056D DEXTROSE (2B0163Q) 10% (BAX) (B) DEXTROSE DEXTROSE (2B0163Q) 500ML B 5.16 5.1648 BAG 50 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 2056D DEXTROSE (2B0163Q) 10% (BAX) DEXTROSE DEXTROSE (2B0163Q) 500ML B 6.52 6.52 BAG 50 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2026-04-01 2028-03-31 IV 0 CALORIC AGENTS
40 20572 DEXTROSE (2B0164X) 10% INJ (BAX/STO) DEXTROSE DEXTROSE (2B0164X) 1 LITRE B 4.97 4.97 INJECTION 0 BOTT BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 20572 DEXTROSE (2B0164X) 10% INJ (BAX) (B) DEXTROSE DEXTROSE (2B0164X) 1 LITRE B 5.74 5.7357 BAG 50 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 20572 DEXTROSE (2B0164X) 10% INJ (BAX) DEXTROSE DEXTROSE (2B0164X) 1 LITRE B 9.95 9.95 BAG 50 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2026-04-01 2028-03-31 IV 0 CALORIC AGENTS
40 20578 DEXTROSE 10% (CSC/PHA) PLASTIC BAG DEXTROSE DEXTROSE 1 LITRE B 4.50 4.50 INJECTION 0 BOTT CSC FORSURE MEDICAL PHA PHARMACY SALES CARIBBEAN 4020 CALORIC AGENTS 2022-04-01 2022-06-15 Price Change IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE 2021-11-10
40 20578 DEXTROSE 10% (CSC/PHA) PLASTIC BAG DEXTROSE DEXTROSE 1 LITRE B 5.01 5.01 INJECTION 0 BOTT CSC FORSURE MEDICAL PHA PHARMACY SALES CARIBBEAN 4020 CALORIC AGENTS 2022-04-16 2024-03-31 Price Change IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE 2022-06-15
41 20578 DEXTROSE 10% (CSC) PLASTIC BAG (B) DEXTROSE DEXTROSE 1 LITRE B 4.08 4.0775 BAG 50 BAG CSC FORSURE MEDICAL PHA PHARMACY SALES CARIBBEAN 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
41 205C1 DEXTROSE 70% INJ (BAX) DEXTROSE DEXTROSE 2 LITRES BQ 36.7517 36.7517 BAG 0 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 205C1 DEXTROSE 70% INJ (BAX) DEXTROSE DEXTROSE 2 LITRES B 11.77 11.77 BAG 0 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4020 CALORIC AGENTS 2026-04-01 2028-03-31 IV 0 CALORIC AGENTS
42 20712 PMS-ATOMOXETINE 10MG CAP (PMS) (C) ATOMOXETINE PMS-ATOMOXETINE 30'S C 32.62 1.09 CAP 60 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
40 20713 APO-ATOMOXETINE 10MG CAP (APO/COL) ATOMOXETINE APO-ATOMOXETINE 30'S C 32.62 1.09 CAPSULE 0 CAP APO APOTEX INC. COL COLLINS LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 20715 APO-ATOMOXETINE 10MG CAP (APO) (C) ATOMOXETINE APO-ATOMOXETINE 30'S C 33.27 1.1091 CAP 60 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
42 20732 PMS-ATOMOXETINE 25MG CAP (PMS) (C) ATOMOXETINE PMS-ATOMOXETINE 30'S C 40.77 1.36 CAP 60 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
40 20733 APO-ATOMOXETINE 25MG CAP (APO/COL) ATOMOXETINE APO-ATOMOXETINE 30'S C 59.80 1.99 CAPSULE 0 CAP APO APOTEX INC. COL COLLINS LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CENTRAL NERVOUS SYSTEM DRUGS
41 20735 APO-ATOMOXETINE 25MG CAP (APO) (C) ATOMOXETINE APO-ATOMOXETINE 30'S C 61 2.0333 CAP 60 BOX APO APOTEX INC. ATB ANSA TRADING BARBADOS LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
41 20742 PMS-ATOMOXETINE 40MG CAP (PMS) (C) ATOMOXETINE PMS-ATOMOXETINE 30'S C 71.9 2.3967 CAP 30 BOTT PMS PHARMASCIENCE COL COLLINS LTD 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU
42 20742 PMS-ATOMOXETINE 40MG CAP (PMS) (C) ATOMOXETINE PMS-ATOMOXETINE 30'S C 48.93 1.63 CAP 30 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 2892 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS 2026-04-01 2028-03-31 ORAL 6 CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOU