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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 22411 FRAMOPTIC D EYE DR (ASL/PHA) DEX/FRAMY/GRAMI DEXAMETHASONE|FRAMYCETIN|GRAMICIDIN FRAMOPTIC D 10ML C 8.07 8.07 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 22411 FRAMOPTIC D 0.05%|0.5%|0.005% EYE/EAR DR (ASL) DEXAMETHASONE (C) DEXAMETHASONE|FRAMYCETIN|GRAMICIDIN FRAMOPTIC D 10ML C 12.72 12.7218 BOTT 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
42 22411 FRAMOPTIC D 0.05%|0.5%|0.005% EYE/EAR DR (ASL) DEXAMETHASONE DEXAMETHASONE|FRAMYCETIN|GRAMICIDIN FRAMOPTIC D 10ML C 11.55 11.55 BOTT 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2026-04-01 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS