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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 23516 PHENYLEPHRINE MINIMS 10% EYE DR (CAM/STO) PHENYLEPHRINE PHENYLEPHRINE MINIMS 20X0.5ML B 94.73 4.74 EYE DROP 0 AMP CAM MORNINGSIDE PHARMACEUTICALS STO BRYDEN STOKES LTD 5224 EENT MYDRIATICS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 23518 PHENYLEPHRINE MINIMS 10% EYE DR (CAM) (BQ) PHENYLEPHRINE PHENYLEPHRINE MINIMS 20X0.5ML BQ 82.53 4.1264 AMPP 0 BOTT CAM MORNINGSIDE PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 5224 EENT MYDRIATICS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT MYDRIATICS
40 23539 PHENYLEPHRINE 10MG/ML INJ (SLS/AHI) PHENYLEPHRINE PHENYLEPHRINE 1ML AMP B 22.07 22.07 INJECTION 0 VIAL SLS SAMARTH LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 121204 ALPHA ADRENERGIC AGONIST 2022-04-01 2022-09-30 IV 0 AUTONOMIC DRUGS 2022-03-29
40 2353D PHRINTEC 10MG/ML IV/IM INJ (UBI/RXP) PHENYLEP PHENYLEPHRINE PHRINTEC 1ML VIAL B 10.60 10.60 INJECTION 0 VIAL UBI UNITED BIOTECH (P) LIMITED RXP RX PRO INC 121204 ALPHA ADRENERGIC AGONIST 2022-04-01 2024-03-31 IV/IM 0 AUTONOMIC DRUGS
41 2353F PHENYLEPHRINE 10MG/ML INJ (OMG) (BQ) PHENYLEPHRINE PHENYLEPHRINE 10X1ML BQ 66.33 6.6327 VIAL 0 BOX OMG OMEGA COL COLLINS LTD 121204 ALPHA ADRENERGIC AGONIST 2024-04-01 2026-03-31 IV/IM/SC 0 ALPHA ADRENERGIC AGONIST
40 23541 PHENYLEPHRINE MINIMS 2.5% EYE DR (CAM/STO) PHENYLEPHRINE PHENYLEPHRINE MINIMS 20X0.5ML B 94.73 4.74 EYE DROP 0 AMP CAM MORNINGSIDE PHARMACEUTICALS STO BRYDEN STOKES LTD 5224 EENT MYDRIATICS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 23548 PHENYLEPHRINE MINIMS 2.5% EYE DR (CAM) (BQ) PHENYLEPHRINE PHENYLEPHRINE MINIMS 20X0.5ML BQ 82.53 4.1264 AMPP 0 BOTT CAM MORNINGSIDE PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 5224 EENT MYDRIATICS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT MYDRIATICS
40 32936 PREPARATION H 0.25% SUPPOS (GSK/COL) PHENYLEP PHENYLEPHRINE PREPARATION H 12'S A 14.08 1.17 SUPPOSITORY 12 SUPP GSK GLAXOSMITHKLINE COL COLLINS LTD 8406 ANTI-INFLAMMATORY AGENTS, TOPICAL 2022-04-01 2024-03-31 TOPICAL 6 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 32936 PREPARATION H 0.25% SUPPOS (GSK) PH PHENYLEPHRINE PREPARATION H 12'S A 14.79 1.2323 SUPP 12 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 8406 ANTI-INFLAMMATORY AGENTS, TOPICAL 2024-04-01 2026-03-31 TOPICAL 6 ANTI-INFLAMMATORY AGENTS, TOPICAL
40 3294S PREPRATION H MULTI-SYMPTOM 0.25% | 1% CR (GSK/COL) PHENYLEPHRINE | PRAMOXINE PHENYLEPHRINE|PRAMOXINE PREPRATION H MULTI-SYMPTOM 26G A 12.69 12.69 CREAM 1 TUBE GSK GLAXOSMITHKLINE COL COLLINS LTD 8406 ANTI-INFLAMMATORY AGENTS, TOPICAL 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 3294S PREPRATION H MULTI-SYMPTOM 0.25%|1% CR (GSK) PHENYLEPHRINE|P GLYCERINE|PHENYLEPHRINE|PRAMOXINE PREPRATION H MULTI-SYMPTOM 26G A 13.35 13.347 TUBE 1 BOX GSK GLAXOSMITHKLINE COL COLLINS LTD 8406 ANTI-INFLAMMATORY AGENTS, TOPICAL 2024-04-01 2026-03-31 TOPICAL 0 ANTI-INFLAMMATORY AGENTS, TOPICAL
41 4061F OPTICOOL 0.05%|0.12% EYE DR (SHC) NAPHAZOLINE|PHENYLEPHRINE NAPHAZOLINE|PHENYLEPHRINE OPTICOOL 10ML A 3.59 3.5882 BOTT 1 BOTT SHC SION HEALTHCARE PSB PHARMACEUTICAL SOLUTIONS BARBA 5232 EENT VASOCONSTRICTORS 2024-04-01 2026-03-31 OPHTHALMIC 0 EENT VASOCONSTRICTORS