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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 0182E PENICILLIN G BENZATHINE 2.4MU INJ (JOL) PENICILLIN G BENZATHINE PENICILLIN G BENZATHINE 20X4ML B 8.1 0.405 VIAL 0 BOX JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2024-04-01 2026-03-31 IM 0 PENICILLINS
41 0192A PENICILLIN G SODIUM 5MU INJ (JOL) (B) PENICILLIN G SODIUM PENICILLIN G SODIUM 3G VIAL B 7.48 7.4754 VIAL 0 VIAL JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2024-04-01 2026-03-31 INJECTION 0 PENICILLINS
42 0192A PENICILLIN G SODIUM 5MU INJ (JOL) PENICILLIN G SODIUM PENICILLIN G SODIUM 5G VIAL B 7.23 7.23 VIAL 0 VIAL JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2026-04-01 IM 0 PENICILLINS
41 0225L CLOXACILLIN 500MG INJ (JOL) (B) CLOXACILLIN CLOXACILLIN 500MG VIAL B 6.31 6.3065 VIAL 56 VIAL JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081216 PENICILLINS 2024-04-01 2026-03-31 IV 6 PENICILLINS
40 3701BE SELECT FLEX PLUS GLUC (JOH/AAL) DIAGNOSTIC B DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 39.42 39.42 GLUCOSE STRI 1 PACK JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2022-04-01 2024-03-31 6 DIAGNOSTIC AGENTS
41 3701BE SELECT FLEX PLUS GLUC (JOH) DIAGNO DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 39.23 39.2254 PACK 1 BOX JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2024-04-01 2026-03-31 6 DIABETES MELLITUS
42 3701BE SELECT FLEX PLUS GLUC (JOH) DIAGNO DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 40.39 40.39 PACK 1 BOX JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2026-04-01 2028-03-31 6 DIABETES MELLITUS
40 3701V LIFESCAN ONE TOUCH ULTRA GLUC (JOH/AAL) DIAG DIAGNOSTIC BLOOD GLUCOSE LIFESCAN ONE TOUCH ULTRA 50'S A 39.42 39.42 GLUCOSE STRI 1 PACK JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2022-04-01 2024-03-31 6 DIAGNOSTIC AGENTS
41 53117 PENICILLAMINE 250MG CAP (JOL) PENICILLAMINE PENICILLAMINE 50'S A 70.49 1.4097 CAP 180 BOX JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 6400 HEAVY METAL ANTAGONISTS 2024-04-01 2026-03-31 ORAL 6 HEAVY METAL ANTAGONISTS
42 53117 PENICILLAMINE 250MG CAP (JOL) PENICILLAMINE PENICILLAMINE 50'S A 46.48 0.93 CAP 180 BLIS JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 6400 HEAVY METAL ANTAGONISTS 2026-04-01 ORAL 6 HEAVY METAL ANTAGONISTS
41 64611 SULPHADIAZINE 500MG TAB (JOL) SILVER SULPHADIAZINE (C) SULPHASALAZINE SULPHADIAZINE 100'S C 76.47 0.7647 TAB 0 BOX JOL JOLLY PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 081220 SULPHONAMIDES 2024-04-01 2026-03-31 ORAL 0 SULPHONAMIDES