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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 0012EY AERIUS 5MG TAB (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 30'S C 25.2 0.84 TAB 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0408 SECOND GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
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 0013BK AERIUS 0.5MG/ML SYR (MSD/STO) DESLORATADINE DESLORATADINE AERIUS 60ML C 11.88 0.198 SYR 60 ML MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 0404 FIRST GENERATION ANTIHISTAMINES ORAL 0 ANTIHISTAMINICS
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
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
41 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 15ML C 29.96 1.9971 SUSP 30 ML PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
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 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN AZITHROMYCIN ZITHROMAX 3'S C 53.52 17.8413 TAB 7 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
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
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
41 0211T INVANZ 1G INJ (MSD/STO) ERTAPENEM ERTAPENEM INVANZ 1GM BQ 82.66 82.66 INJ 28 VIAL MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 08120708 CARBAPENEMS IV/IM/SC 1 ANTI-INFECTIVE AGENTS
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
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
41 0212BE MERREM 1G INJ (PFI/STO) MEROPENEM MEROPENEM MERREM 10X1G C 879.6 87.9595 INJ 42 VIAL PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 08120708 CARBAPENEMS IV 2 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 02316 DULERA 5MCG|100MCG INHR (MSD/STO) FORMOTEROL|MOMETASONE FORMOTEROL|MOMETASONE DULERA 120 DOSES C 58.39 58.3896 INHR 1 INHR MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
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 02326 DULERA 200MCG/5MCG INHR (MSD/STO) MOMETASONE/ FORMOTEROL|MOMETASONE DULERA 120 DOSES B 61.03 61.0264 INHR 1 INHR MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
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