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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 42524 BNT 3.5MG | 10,000IU CR (CAR/COL) NEOMYCIN | POLY NEOMYCIN|POLYMYXIN BNT 15G A 5.38 5.38 CREAM 2 TUBE CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840404 ANTIBIOTICS TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 42524 BNT 3.5MG|10,000IU CR (CAR) NEOMYCIN|POL NEOMYCIN|POLYMYXIN BNT 15G A 5.55 5.5454 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 840404 ANTIBIOTICS TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTIBIOTICS TOPICAL
42 42524 BNT 3.5MG/G|10,000IU/G CR (CAR) NEOMYCIN|POLYMYXIN NEOMYCIN|POLYMYXIN BNT 15G A 5.55 5.55 TUBE 2 BOX CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 840404 ANTIBIOTICS TOPICAL 2026-04-01 TOPICAL 0 ANTIBIOTICS TOPICAL
40 6451AA MAXITROL 1MG/ML | 3MG/ML | 10,000U EYE DR (NVS/COL) DEXAMETHASONE | NEOMYCIN | P More ... DEXAMETHASONE|NEOMYCIN|POLYMYXIN B MAXITROL 5ML BQ 32.08 32.08 EYE DROP 0 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 6451M MAXISPORIN 1MG/ML | 3MG EYE DR (ASL/PHA) DEXAMETHASONE | NEOMYCIN | POLYMYXIN B DEXAMETHASONE|NEOMYCIN|POLYMYXIN B MAXISPORIN 5ML BQ 5.52 5.52 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS