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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 4121B METHYLPREDNISOLONE SODIUM SUCCINATE 500MG INJ (KWA/ATB) METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPREDNISOLONE SODIUM SUCCINATE 500MG VIAL B 15.36 15.36 INJECTION 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 6804 ADRENALS 2022-04-01 2022-09-30 IV 0 HORMONES AND SYNTHETIC SUBSTITUTES 2022-03-30
41 4121B METHYLPRED. SOD. SUCC. 500MG INJ (KWA) METHYLPREDNISOLONE SO (BQ) METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPRED. SOD. SUCC. 500MG VIAL BQ 9.7 9.7044 VIAL 0 VIAL KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 6804 ADRENALS 2024-04-01 2026-03-31 IV 0 ADRENALS
40 4121D METHYLPREDNISOLONE SODIUM SUCCINATE 500MG INJ (MON/PHA) METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPREDNISOLONE SODIUM SUCCINATE 10ML VIAL B 10.55 10.55 INJECTION 0 VIAL MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 6804 ADRENALS 2022-04-01 2024-03-31 IV 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 4121G METHYLPRED. SOD. SUCC. 500MG INJ (FSB) METHYLPREDNISOLONE SO (BQ) METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPRED. SOD. SUCC. 500MG VIAL BQ 9.43 9.4326 VIAL 0 VIAL FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 6804 ADRENALS 2024-04-01 2026-03-31 IV/IM 0 ADRENALS
42 4121J METHYLPRED. SOD. SUCC. 50MG/ML INJ (BAX) METHYLPREDNISOLONE METHYLPREDNISOLONE SODIUM SUCCINATE METHYLPRED. SOD. SUCC. 10X10ML BQ 68.42 6.84 VIAL 0 VIAL BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 6804 ADRENALS 2026-04-01 IV/IM 0 ADRENALS