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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 43664 BURETROL INTERLINK ( 2C7564) SET (BAX/STO) ADMIN SET PAED BURETROL INTERLINK ( 2C7564) SET B 16.74 16.74 SET 0 SET BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
41 43664 BURETROL INTERLINK ( 2C7564) SET (BAX) (B) ADMIN SET PAED BURETROL INTERLINK ( 2C7564) SET B 23.76 23.7582 SET 10 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
42 43664 BURETROL INTERLINK ( 2C7564) SET (BAX) ADMIN SET PAED BURETROL INTERLINK ( 2C7564) SET B 30.72 30.72 SET 10 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2026-04-01 2028-03-31 0 MEDICAL DEVICES
40 4366R BURETROL ADD ON CLEARLINK SET (BAX/STO) ADMI ADMIN SET PAED BURETROL ADD ON CLEARLINK SET B 12.37 12.37 SET 0 SET BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
41 4366R BURETROL ADD ON CLEARLINK SET (BAX) ADM (B) ADMIN SET PAED BURETROL ADD ON CLEARLINK SET B 17.91 17.9138 SET 10 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES
42 4366R BURETROL ADD ON CLEARLINK SET (BAX) ADM ADMIN SET PAED BURETROL ADD ON CLEARLINK SET B 18.65 18.65 SET 10 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2026-04-01 0 MEDICAL DEVICES
40 4366S BURETROL SOL PAED (2C8862) SET (BAX/STO) ADM ADMIN SET PAED BURETROL SOL PAED (2C8862) SET B 15.85 15.85 SET 0 SET BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2022-04-01 2024-03-31 0 MEDICAL DEVICES
41 4366S BURETROL SOL PAED (2C8862) SET (BAX) AD (B) ADMIN SET PAED BURETROL SOL PAED (2C8862) SET B 20.96 20.9583 SET 10 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 9400 MEDICAL DEVICES 2024-04-01 2026-03-31 0 MEDICAL DEVICES