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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 A7512 SANDOSTATIN 0.1MG/ML INJ (NVS/COL) OCTREOTIDE OCTREOTIDE SANDOSTATIN 5X1ML BQ 174.52 34.90 INJECTION 0 AMP NVS NOVARTIS CARIBE SA COL COLLINS LTD 9292 OTHER THERAPEUTIC AGENTS 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 A7512 SANDOSTATIN 0.1MG/ML INJ (NVS) OCTREOTID (BQ) OCTREOTIDE SANDOSTATIN 5X1ML BQ 174.52 34.9033 AMP 20 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD 9292 OTHER THERAPEUTIC AGENTS 2024-04-01 2026-03-31 IV 6 OTHER THERAPEUTIC AGENTS
42 A7512 SANDOSTATIN 0.1MG/ML INJ (NVS) OCTREOTID OCTREOTIDE SANDOSTATIN 5X1ML BQ 174.52 34.90 AMPG 20 BOX NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 9292 OTHER THERAPEUTIC AGENTS 2026-04-01 IV 0 OTHER THERAPEUTIC AGENTS
40 A7513 SANDOSTATIN LAR 20MG INJ (NVS/COL) OCTREOTIDE OCTREOTIDE SANDOSTATIN LAR 20MG VIAL BQ 3,860.02 3,860.02 INJECTION 0 VIAL NVS NOVARTIS CARIBE SA COL COLLINS LTD 9292 OTHER THERAPEUTIC AGENTS 2022-04-01 2024-03-31 IV 6 UNCLASSIFIED THERAPEUTIC AGENTS
41 A7513 SANDOSTATIN LAR 20MG INJ (NVS) OCTREOTID (BQ) OCTREOTIDE SANDOSTATIN LAR 20MG VIAL BQ 3860.02 3860.0201 VIAL 20 VIAL NVS NOVARTIS CARIBE SA COL COLLINS LTD 9292 OTHER THERAPEUTIC AGENTS 2024-04-01 2026-03-31 IV 6 OTHER THERAPEUTIC AGENTS
42 A7513 SANDOSTATIN LAR 20MG INJ (NVS) OCTREOTID OCTREOTIDE SANDOSTATIN LAR 20MG VIAL BQ 3,860.02 3,860.02 VIAL 20 VIAL NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 9292 OTHER THERAPEUTIC AGENTS 2026-04-01 IV 0 OTHER THERAPEUTIC AGENTS
40 A751D OCTREOTIDE 0.1MG/ML INJ (DIL/AHI) OCTREOTIDE OCTREOTIDE 10X1ML BQ 24.55 2.46 INJECTION 0 VIAL DIL FRESENIUS KABI AHI ARMSTRONG HEALTHCARE INC 9292 OTHER THERAPEUTIC AGENTS 2022-04-01 2024-03-31 IV 0 UNCLASSIFIED THERAPEUTIC AGENTS
41 A751L OCTREOTIDE 0.1MG/ML INJ (CHC) (BQ) OCTREOTIDE OCTREOTIDE 1ML AMP BQ 12.5 12.5043 AMP 20 AMP CHC CARITAS HEALTHCARE PVT LTD ATB ANSA TRADING BARBADOS LTD 9292 OTHER THERAPEUTIC AGENTS 2024-04-01 2026-03-31 IV/SC 6 OTHER THERAPEUTIC AGENTS