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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
42 30242 LIDOCAINE 2% JELLY (PDN) LIDOCAINE LIDOCAINE 50X30G B 3.64 0.07 TUBE 0 TUBE PDN PHARMA DANICA A/S PHA PHARMACY SALES CARIBBEAN 7200 LOCAL ANESTHETICS 2026-04-01 TOPICAL 0 LOCAL ANESTHETICS
40 3181D BENZYLBENZOATE 25% EMUL (PDN/PHA) BENZYLBENZOATE BENZYLBENZOATE 1 LITRE A 21.72 0.02 EMULSION 100 ML PDN PHARMA DANICA A/S PHA PHARMACY SALES CARIBBEAN 840412 SCABICIDES AND PEDICULICIDES 2022-04-01 2024-03-31 TOPICAL 6 SKIN-MUCOUS MEMBRANE PREPARATIONS