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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 67911 PHARIXIA 0.15% RINSE (PMS/COL) BENZYDAMINE BENZYDAMINE PHARIXIA 250ML BQ 8.83 8.83 ORAL RINSE 0 BOTT PMS PHARMASCIENCE COL COLLINS LTD 5228 MOUTH WASHES AND GARGLES 2022-04-01 2024-03-31 TOPICAL 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 67911 PHARIXIA 0.15% RINSE (PMS) BENZYDAMINE BENZYDAMINE PHARIXIA 250ML BQ 14 13.9994 BOTT 0 BOTT PMS PHARMASCIENCE COL COLLINS LTD 5228 MOUTH WASHES AND GARGLES 2024-04-01 2026-03-31 TOPICAL 0 MOUTH WASHES AND GARGLES
42 67911 PMS-BENZYDAMINE 0.15% RINSE (PMS) BENZYDAMINE PMS-BENZYDAMINE 250ML B 9.51 9.51 BOTT 0 BOTT PMS PHARMASCIENCE COL AVENTA BARBADOS 5228 MOUTH WASHES AND GARGLES 2026-04-01 TOPICAL 0 MOUTH WASHES AND GARGLES