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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 9991BS UREA | GLYCERINE 10% | 5% CR (CAR/COL) UREA|GLYCERINE UREA|GLYCERINE 100G B 13.59 0.14 CREAM 0 GRAM CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 9991BS UREA|GLYCERINE 10%|5% CR (CAR) (B) UREA|GLYCERINE UREA|GLYCERINE 100G B 14.95 0.1495 GRAM 2 Tube CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2024-04-01 2026-03-31 TOPICAL 6 EMOLLIENTS, DEMULCENTS AND PROTECTANTS
42 9991BS UREA|GLYCERINE 10%|5% CR (CAR) UREA|GLYCERINE UREA|GLYCERINE 100G B 14.95 0.15 GRAM 2 Tube CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-04-01 TOPICAL 6 EMOLLIENTS, DEMULCENTS AND PROTECTANTS
40 9991BT UREA | GLYCERINE 5% | 10% CR (CAR/COL) UREA|GLYCERINE UREA|GLYCERINE 100G B 12.23 0.12 CREAM 0 GRAM CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 9991BT UREA|GLYCERINE 5%|10% CR (CAR) (B) UREA|GLYCERINE UREA|GLYCERINE 100G B 12.23 0.1223 GRAM 2 Tube CAR CARLISLE LABORATORIES LTD COL COLLINS LTD 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2024-04-01 2026-03-31 TOPICAL 6 EMOLLIENTS, DEMULCENTS AND PROTECTANTS
42 9991BT UREA|GLYCERINE 5%|10% CR (CAR) UREA|GLYCERINE UREA|GLYCERINE 100G B 12.23 0.12 GRAM 2 Tube CAR CARLISLE LABORATORIES LTD COL AVENTA BARBADOS 8424 EMOLLIENTS, DEMULCENTS AND PROTECTANTS 2026-04-01 TOPICAL 6 EMOLLIENTS, DEMULCENTS AND PROTECTANTS