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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 0012EY AERIUS 5MG TAB (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 30'S C 24.95 0.83 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0012EY AERIUS 5MG TAB (MSD) DESLORATADINE (C) DESLORATADINE AERIUS 30'S C 25.2 0.84 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0408 SECOND GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 SECOND GENERATION ANTIHISTAMINES
40 0013BK AERIUS 0.5MG/ML SYR (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 60ML C 11.74 0.20 SYRUP 0 ML MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0408 SECOND GENERATION ANTIHISTAMINES 2022-04-01 2024-03-31 Oral 0 ANTIHISTAMINICS
41 0013BK AERIUS 0.5MG/ML SYR (MSD) DESLORATADINE (C) DESLORATADINE AERIUS 60ML C 11.88 0.198 ML 60 BOTT MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0404 FIRST GENERATION ANTIHISTAMINES 2024-04-01 2026-03-31 ORAL 0 FIRST GENERATION ANTIHISTAMINES
40 01261 CHLORAMPHENICOL MINIMS 0.5% EYE DR (CAM/STO) CHLORAMPHENICOL CHLORAMPHENICOL MINIMS 20X0.5ML BQ 94.73 4.74 EYE DROP 0 AMP CAM MORNINGSIDE PHARMACEUTICALS STO BRYDEN STOKES LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 Ophthalmic 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 15ML C 29.66 1.98 SUSPENSION 0 ML PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHRO (C) AZITHROMYCIN ZITHROMAX 15ML C 29.96 1.9971 ML 30 BOTT PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 3'S C 53.01 17.67 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
41 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY (C) AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.8413 TAB 7 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES 2024-04-01 2026-03-31 ORAL 0 OTHER MACROLIDES
40 02112 INVANZ 1G INJ (MSD/STO) ERTAPENEM ERTAPENEM INVANZ 10X1G C 924.23 92.42 INJECTION 0 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
40 0211AG MERREM 500MG INJ (PFI/STO) MEROPENEM MEROPENEM MERREM 10X500MG C 561.20 56.12 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
40 0211T INVANZ 1G INJ (MSD/STO) ERTAPENEM ERTAPENEM INVANZ 1G VIAL C 92.42 92.42 INJECTION 0 VIAL MSD MERK SHARP & DOHME STO BRYDEN STOKES 08120708 CARBAPENEMS 2023-02-22 2024-03-31 PACKAGE SIZE CHANGE IV 2023-02-22
40 0211T INVANZ 1G INJ (MSD/STO) ERTAPENEM (C) ERTAPENEM INVANZ 1GM C 92.42 92.42 INJECTION MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 8120708 CARBAPENEMS 2023-03-20 2024-03-31 Add to Contract as Cat C IV/IM/SC CARBAPENEMS 2023-02-22
41 0211T INVANZ 1G INJ (MSD) ERTAPENEM (BQ) ERTAPENEM INVANZ 1GM BQ 82.66 82.66 VIAL 28 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2024-04-01 2026-03-31 IV/IM/SC 1 CARBAPENEMS
40 02128 PRIMAXIN 500MG INJ (MSD/STO) IMIPENEM/CILASTA CILASTATIN|IMIPENEM PRIMAXIN 25X500MG BQ 665.99 26.64 INJECTION 0 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
40 0212BE MERREM 1G INJ (PFI/STO) MEROPENEM MEROPENEM MERREM 10X1G C 968.73 96.87 INJECTION 0 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
41 0212BE MERREM 1G INJ (PFI) MEROPENEM (C) MEROPENEM MERREM 10X1G C 879.6 87.9595 VIAL 42 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS 2024-04-01 2026-03-31 IV 2 CARBAPENEMS
40 02316 DULERA 5MCG | 100MCG INHR (MSD/STO) FORMOTEROL | MOMETASONE FORMOTEROL|MOMETASONE DULERA 120 DOSES B 56.68 56.68 INHALER 1 INHR MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 4892 RESPIRATORY AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
41 02316 DULERA 5MCG|100MCG INHR (MSD) FORMOTEROL|MOMETASONE (C) FORMOTEROL|MOMETASONE DULERA 120 DOSES C 58.39 58.3896 INHR 1 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS
40 02326 DULERA 200MCG/5MCG INHR (MSD/STO) MOMETASONE/ FORMOTEROL|MOMETASONE DULERA 120 DOSES B 59.26 59.26 INHALER 1 INHR MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 4892 RESPIRATORY AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS