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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
42 9991AF UREA|GLYCERINE 5%|10% CR (CHC) GLYCERINE|UREA GLYCERINE|UREA UREA|GLYCERINE 50G TUBE B 2.50 2.50 TUBE 1 CHC CARITAS HEALTHCARE PVT LTD STO BRYDEN STOKES LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-04-01 Add to Contract as Cat B TOPICAL 0 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-03-05
42 9991CJ UREA|GLYCERINE 10%|5% CR (CHC) GLYCERINE|UREA GLYCERINE|UREA UREA|GLYCERINE 50G TUBE B 2.50 2.50 TUBE 0 CHC CARITAS HEALTHCARE PVT LTD STO BRYDEN STOKES LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-04-01 Add to Contract as Cat B TOPICAL 0 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-03-05