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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 12718 KETAMINE 50MG/ML INJ (RTM) KETAMINE KETAMINE 25X10ML BQ 129.12 5.16 VIAL 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2026-04-01 IV 0 GENERAL ANAESTHETICS MISCELLANEOUS
40 1271A KETAMINE 50MG/ML INJ (RTM/PHA) KETAMINE KETAMINE 10ML VIAL BQ 7.26 7.26 INJECTION 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2022-04-01 2022-05-31 IV 0 CENTRAL NERVOUS SYSTEM DRUGS
40 1271A KETAMINE 50MG/ML INJ (RTM/PHA) KETAMINE KETAMINE 10ML VIAL BQ 11.34 11.34 INJECTION 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2022-06-01 2024-03-31 Price Change IV 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-05-31
41 1271A KETAMINE 50MG/ML INJ (RTM) (BQ) KETAMINE KETAMINE 10ML VIAL BQ 11.44 11.4441 VIAL 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2024-04-01 2025-01-28 IV 0 GENERAL ANAESTHETICS MISCELLANEOUS
41 1271A KETAMINE 50MG/ML INJ (RTM) (BQ) KETAMINE KETAMINE 10ML VIAL BQ 15.43 15.43 VIAL 0 VIAL RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2024-05-22 2026-03-31 IV 0 GENERAL ANAESTHETICS MISCELLANEOUS 2024-05-21
40 1271D KETAMINE 50MG/ML INJ (STP/COL) KETAMINE KETAMINE 100X10ML BQ 339.79 3.40 INJECTION 0 VIAL STP STEROP LABORATORIES COL COLLINS LTD 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2022-04-01 2022-05-13 Delete from contract IV 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-04-01
42 1271M KETAMINE 50MG/ML INJ (BAX) KETAMINE KETAMINE 5X10ML BQ 26.42 5.28 VIAL 0 VIAL BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2026-04-01 IV 0 GENERAL ANAESTHETICS MISCELLANEOUS
40 1271P KETAMINE 50MG/ML INJ (STP/COL) KETAMINE KETAMINE 10X10ML BQ 33.98 3.40 INJECTION 0 AMP STP STEROP LABORATORIES COL COLLINS LTD 280492 GENERAL ANAESTHETICS MISCELLANEOUS 2022-04-01 2024-03-31 Package Size Change IV 0 CENTRAL NERVOUS SYSTEM DRUGS 2022-03-28