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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 07918 ADRENALINE 1MG/ML IV/IM INJ (RTM/PHA) ADRENALINE ADRENALINE 10X1ML B 35.01 3.50 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-06-01 2024-03-31 Price Change IV/IM 0 AUTONOMIC DRUGS 2022-05-31
40 07918A ADRENALINE 1MG/ML IV/IM INJ (RTM/PHA) ADRENALINE ADRENALINE 10X1ML B 24.14 2.41 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2022-05-31 IV/IM 0 AUTONOMIC DRUGS
40 0791AF ADRENALINE 1MG/ML IV/IM INJ (MON/PHA) ADRENALINE ADRENALINE 10X1ML B 7.07 0.71 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV/IM 0 AUTONOMIC DRUGS
40 0791X ADRENALINE 1MG/ML IV/IM INJ (LAF/AHI) ADRENALINE ADRENALINE 100X1ML B 99.38 0.99 INJECTION 0 AMP LAF LABORATORIOS ALFA AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 Change Local Agent IV/IM 0 AUTONOMIC DRUGS 2022-02-03
41 0791X ADRENALINE 1MG/ML IV/IM INJ (LAF) (B) ADRENALINE ADRENALINE 100X1ML B 114.17 1.1417 AMP 60 BOX LAF LABORATORIOS ALFA AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM 0 ALPHA & BETA ADRENERGIC AGONIST
41 0791Y ADRINOR 1MG/ML IV/IM INJ (INC) ADRENALINE (B) ADRENALINE ADRINOR 5X1ML B 9.05 1.8104 AMP 60 BOX INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM/SC 0 ALPHA & BETA ADRENERGIC AGONIST
40 0861E NORADRENALINE 1MG/ML INJ (KWA/ATB) NORADRENALINE NORADRENALINE 10X4ML BQ 27.05 2.71 INJECTION 0 AMP KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0861E NORADRENALINE 1MG/ML INJ (KWA) (BQ) NORADRENALINE NORADRENALINE 10X4ML BQ 10.55 1.0547 AMP 0 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV 0 ALPHA & BETA ADRENERGIC AGONIST
40 0861F NORADRENALINE 1MG/ML INJ (MON/PHA) NORADRENALINE NORADRENALINE 5X4ML BQ 16.55 3.31 INJECTION 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 121212 ALPHA & BETA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
41 0861H LADRELINE 1MG/ML INJ (LDP) NORADRENALINE (BQ) NORADRENALINE LADRELINE 5X4ML BQ 14.19 2.8379 AMP 0 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 121212 ALPHA & BETA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM 0 ALPHA & BETA ADRENERGIC AGONIST
40 30316 ADRENALINE | LIDOCAINE 0.001% | 1% INJ (FSB/ATB) ADRENALINE|LIDOCAINE ADRENALINE|LIDOCAINE 30ML B 3.94 3.94 INJECTION 0 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 7200 LOCAL ANESTHETICS 2022-04-01 2024-03-31 Add to Contract as Cat B IV 0 LOCAL ANESTHETICS 2021-11-18
41 30317 ADRENALINE|LIDOCAINE 0.001%|1% INJ (KWA) ADRENALINE|LIDOCAINE ADRENALINE|LIDOCAINE 30ML B 7.4754 7.4754 VIAL 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 7200 LOCAL ANESTHETICS 2024-04-01 2026-03-31 IV 0 LOCAL ANESTHETICS
40 3032C ADRENALINE | LIDOCAINE 0.001% | 2% INJ (FSB/ATB) ADRENALINE|LIDOCAINE ADRENALINE|LIDOCAINE 30ML B 4.08 4.08 INJECTION 0 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 7200 LOCAL ANESTHETICS 2022-04-01 2024-03-31 Add to Contract as Cat B IV 0 LOCAL ANESTHETICS 2021-11-18