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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 3051AB OXYTOCIN 10U/ML INJ (LAF) OXYTOCIN OXYTOCIN 100X1ML BQ 86.04 0.86 VIAL 0 VIAL LAF LABORATORIOS ALFA AHI ARMSTRONG HEALTHCARE INC 7600 OXYTOCICS 2026-04-01 IV 0 OXYTOCICS
40 3051E OXYTOCIN 10U/ML INJ (RTM/PHA) OXYTOCIN OXYTOCIN 10X1ML BQ 9.68 0.97 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 7600 OXYTOCICS 2022-04-01 2022-05-31 IV 0 OXYTOCICS
40 3051E OXYTOCIN 10U/ML INJ (RTM/PHA) OXYTOCIN OXYTOCIN 10X1ML BQ 12.40 1.24 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 7600 OXYTOCICS 2022-06-01 2024-03-31 Price Change IV 0 OXYTOCICS 2022-05-31
41 3051E OXYTOCIN 10U/ML INJ (RTM) (BQ) OXYTOCIN OXYTOCIN 10X1ML BQ 10.33 1.033 AMP 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 7600 OXYTOCICS 2024-04-01 2026-03-31 IV 0 OXYTOCICS
42 3051E OXYTOCIN 10U/ML INJ (RTM) OXYTOCIN OXYTOCIN 10X1ML BQ 10.33 1.03 AMPG 0 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 7600 OXYTOCICS 2026-04-01 IV 0 OXYTOCICS
41 3051W OXYTOCIN 10U/ML INJ (KWA) (BQ) OXYTOCIN OXYTOCIN 10X1ML BQ 8.32 0.8318 AMP 0 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 7600 OXYTOCICS 2024-04-01 2026-03-31 IV 0 OXYTOCICS