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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
41 23012 OXYBUPROCAINE MINIMS 0.4% EYE DR (CAM) (B) OXYBUPROCAINE OXYBUPROCAINE MINIMS 20X0.5ML B 82.53 4.1264 BOX 4 AMPP CAM MORNINGSIDE PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 5216 EENT LOCAL ANESTHETIC 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT LOCAL ANESTHETIC
40 23016 OXYBUPROCAINE MINIMS 0.4% EYE DR (CAM/STO) OXYBUPROCAINE OXYBUPROCAINE MINIMS 20X0.5ML B 94.73 4.74 EYE DROP 0 AMP CAM MORNINGSIDE PHARMACEUTICALS STO BRYDEN STOKES LTD 5216 EENT LOCAL ANESTHETIC 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS