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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 2721C TRIAM-DENK 40MG/ML INJ (EDK/COL) TRIAMCINOLON TRIAMCINOLONE TRIAM-DENK 10X1ML B 27.86 2.79 INJECTION 0 VIAL EDK DENK PHARMA GMBH & CO. KG. COL COLLINS LTD 6804 ADRENALS 2022-04-01 2024-03-31 IV 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 2721C TRIAM-DENK 40MG/ML INJ (EDK) TRIAMCINOLO (B) TRIAMCINOLONE TRIAM-DENK 10X1ML B 30.88 3.088 VIAL 4 BOX EDK DENK PHARMA GMBH & CO. KG. COL COLLINS LTD 6804 ADRENALS 2024-04-01 2026-03-31 IV 6 ADRENALS
42 2721C TRIAM-DENK 40MG/ML INJ (EDK) TRIAMCINOLO TRIAMCINOLONE TRIAM-DENK 10X1ML B 32.62 3.26 VIAL 4 VIAL EDK DENK PHARMA GMBH & CO. KG. COL AVENTA BARBADOS 6804 ADRENALS 2026-04-01 IV 6 ADRENALS
40 2721N TRIAMCINOLONE 40MG/ML INJ (CIR/AHI) TRIAMCINOLONE TRIAMCINOLONE 1ML VIAL B 2.99 2.99 INJECTION 0 VIAL CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2022-04-01 2024-03-31 IV 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 2721N TRIAMCINOLONE 40MG/ML INJ (CIR) (B) TRIAMCINOLONE TRIAMCINOLONE 1ML VIAL B 3.29 3.2892 VIAL 4 VIAL CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 6804 ADRENALS 2024-04-01 2026-03-31 IV 6 ADRENALS
42 2721U TRIAM-DENK 40MG/ML INJ (EDK) TRIAMCINOLONE TRIAMCINOLONE TRIAM-DENK 5ML B 32.62 32.62 VIAL 4 AMP EDK DENK PHARMA GMBH & CO. KG. SBI MASSY DISTRIBUTION (BDOS) LTD 6804 ADRENALS 2026-04-01 INJECTION 6 ADRENALS
40 3653T NASACORT AQ 55MCG NASAL SP (SFA/COL) TRIAMCIN TRIAMCINOLONE NASACORT AQ 120 DOSES A 12.23 12.23 NASAL SPRAY 1 BOTT SFA SANOFI AVENTIS COL COLLINS LTD 5208 EENT ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 NASAL 6 EYE, EAR, NOSE AND THROAT PREPARATIONS