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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 1201P AZARGA 1% | 0.5% EYE DR (NVS/COL) BRINZOLAMIDE | BRINZOLAMIDE|TIMOLOL AZARGA 5ML C 19.79 19.79 EYE DROP 0 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 1201P AZARGA 1%|0.5% EYE DR (NVS) BRINZOLAMIDE|TIMOLOL (BQ) BRINZOLAMIDE|TIMOLOL AZARGA 5ML BQ 19.79 19.7894 BOTT 1 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2024-04-01 2026-03-31 OPHTHALMIC 6 ANTIGLAUCOMA AGENTS MISCELLANEOUS
42 1201P AZARGA 1%|0.5% EYE DR (NVS) BRINZOLAMIDE|TIMOLOL BRINZOLAMIDE|TIMOLOL AZARGA 5ML BQ 19.79 19.79 BOTT 1 BOTT NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2026-04-01 OPHTHALMIC 0 ANTIGLAUCOMA AGENTS MISCELLANEOUS