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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 | 37318 | BOOSTRIX PFS 8MCG | 2.5LF | 5LF INJ (GSK/COL) ACELLULAR PERTUSSIS | DIPHTHERIA T More ... | ACELLULAR PERTUSSIS|DIPHTHERIA TOXOID|TETANUS TOXOID | BOOSTRIX PFS | 1 DOSE | B | 55.45 | 55.45 | INJECTION | 0 | VIAL | GSK | GLAXOSMITHKLINE | COL | COLLINS LTD | 8008 | TOXOIDS | 2022-04-01 | 2024-03-31 | IV | 0 | SERUMS, TOXOIDS AND VACCINES | |||||
| 41 | 37318 | BOOSTRIX PFS 8MCG|2.5LF|5LF INJ (GSK) ACELLULAR PERTUSSIS|DI (B) | ACELLULAR PERTUSSIS|DIPHTHERIA TOXOID|TETANUS TOXOID | BOOSTRIX PFS | 1 DOSE | B | 58.77 | 58.7702 | VIAL | 0 | VIAL | GSK | GLAXOSMITHKLINE | COL | COLLINS LTD | 8012 | VACCINES | 2024-04-01 | 2026-03-31 | IV | 0 | VACCINES | |||||
| 42 | 37318 | BOOSTRIX PFS 8MCG|2.5LF|5LF INJ (GSK) ACELLULAR PERTUSSIS|DI | ACELLULAR PERTUSSIS|DIPHTHERIA TOXOID|TETANUS TOXOID | BOOSTRIX PFS | 1 DOSE | B | 59.01 | 59.01 | VIAL | 0 | VIAL | GSK | GLAXOSMITHKLINE | COL | AVENTA BARBADOS | 8012 | VACCINES | 2026-04-01 | IV | 0 | VACCINES | ||||||