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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 42313 SILVER NITRATE 95% STICK (BRH/PHA) SILVER NITRATE SILVER NITRATE 1'S B 8.29 8.29 STICK 0 EACH BRH BRAY HEALTHCARE PHA PHARMACY SALES CARIBBEAN 8436 MUCOUS-SKIN PREPARATIONS,MISCE LLANEOUS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 42313 SILVER NITRATE 95% STICK (BRH) (B) SILVER NITRATE SILVER NITRATE 1'S B 9.68 9.6772 EACH 2 BOX BRH BRAY HEALTHCARE PHA PHARMACY SALES CARIBBEAN 8436 MUCOUS-SKIN PREPARATIONS,MISCE LLANEOUS 2024-04-01 2026-03-31 TOPICAL 0 MUCOUS-SKIN PREPARATIONS,MISCE LLANEOUS
42 42313 SILVER NITRATE 95% STICK (BRH) SILVER NITRATE SILVER NITRATE 1'S B 9.02 9.02 EACH 2 BOX BRH BRAY HEALTHCARE PHA PHARMACY SALES CARIBBEAN 8436 MUCOUS-SKIN PREPARATIONS,MISCE LLANEOUS 2026-04-01 TOPICAL 0 MUCOUS-SKIN PREPARATIONS,MISCE LLANEOUS