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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 0314L BACTIGRAS 10CMX10CM (SMN/IMS) CHLORHEXIDINE CHLORHEXIDINE BACTIGRAS 10'S A 29.00 2.90 10 EACH SMN SMITH & NEPHEW PHARMACEUTICALS IMS ISLANDS MEDICAL SUPPLIES INC 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2022-04-06 2024-03-31 Add to Contract as Cat A TOPICAL 6 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-04-06
41 0314L BACTIGRAS 10CMX10CM (SMN) CHLORHEXIDINE CHLORHEXIDINE BACTIGRAS 10'S A 31.75 3.175 EACH 10 BOX SMN SMITH & NEPHEW PHARMACEUTICALS IMS ISLANDS MEDICAL SUPPLIES INC 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2024-04-01 2026-03-31 TOPICAL 0 ANTI-INFECTIVES TOPICAL MISCELLANEOUS
40 3203F HEXITANE 5% SOLN (GNT/AHI) CHLORHEXIDINE CHLORHEXIDINE HEXITANE 4 LITRES B 49.39 12.35 SOLUTION 0 BOTT GNT GENETHICS LTD AHI ARMSTRONG HEALTHCARE INC 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 9991BH CHLORHEXIDINE IN SPIRITS (CAR/COL) CHLORHEXIDINE IN SPIRITS CHLORHEXIDINE IN SPIRITS 2 LITRES B 66.06 0.03 SOLUTION 0 ML CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 9991BH CHLORHEXIDINE IN SPIRITS (CAR) (B) CHLORHEXIDINE IN SPIRITS CHLORHEXIDINE IN SPIRITS 2 LITRES B 108.73 0.0544 ML 2000 BOTT CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2024-04-01 2026-03-31 TOPICAL 0 ANTI-INFECTIVES TOPICAL MISCELLANEOUS
42 9991BH CHLORHEXIDINE IN SPIRITS (CAR) CHLORHEXIDINE IN SPIRITS CHLORHEXIDINE IN SPIRITS 2 LITRES B 108.73 0.05 ML 2000 BOTT CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840492 ANTI-INFECTIVES TOPICAL MISCELLANEOUS 2026-04-01 TOPICAL 0 ANTI-INFECTIVES TOPICAL MISCELLANEOUS