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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 14641 TEGRETOL CR 400MG TAB (NVS/COL) CARBAMAZEPINE CARBAMAZEPINE CR TEGRETOL CR 30'S A 21.94 0.73 TABLET 120 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 14641 TEGRETOL CR 400MG TAB (NVS) CARBAMAZEPINE CR CARBAMAZEPINE CR TEGRETOL CR 30'S A 21.94 0.7313 TABCR 120 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
40 14651 TEGRETOL CR 200MG TAB (NVS/COL) CARBAMAZEPINE CARBAMAZEPINE CR TEGRETOL CR 50'S A 17.23 0.34 TABLET 240 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS