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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 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID 60ML C 15.79 0.26 SUSPENSION 0 ML ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID 60ML C 15.79 0.2632 SUSPENSION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8121292 OTHER MACROLIDES 2022-04-01 2023-03-31 Delete from contract Oral 0 OTHER MACROLIDES 2023-03-02
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID 60ML C 11.50 0.19 SUSPENSION 0 ML ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID 60ML C 11.5 0.1917 SUSPENSION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8121292 OTHER MACROLIDES 2022-04-01 2023-03-31 Delete from contract Oral 0 OTHER MACROLIDES 2023-03-02
41 0131DU KLARICID 50MG/ML SUSP (ABB/SBI) CLARITHROMYCIN CLARITHROMYCIN KLARICID 60ML C 19 0.3167 SUSP 60 ML ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
41 0131DV KLARICID 25MG/ML SUSP (ABB/SBI) CLARITHROMYCIN CLARITHROMYCIN KLARICID 60ML C 14.22 0.2369 SUSP 100 ML ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
40 0141FU KLARICID XL 500MG TAB (ABB/PHA) CLARITHROMYCI CLARITHROMYCIN KLARICID XL 10'S C 16.66 1.67 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Oral 0 ANTI-INFECTIVE AGENTS
40 0141FU KLARICID XL 500MG TAB (ABB/PHA) CLARITHROMYCI (C) CLARITHROMYCIN KLARICID XL 10'S C 16.66 1.666 TABLET IMMED ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8121292 OTHER MACROLIDES 2022-04-01 2023-03-31 Delete from contract Oral 0 OTHER MACROLIDES 2023-03-02
40 0141FV KLARICID 500MG TAB (ABB/PHA) CLARITHROMYCIN CLARITHROMYCIN KLARICID 10'S C 16.72 1.67 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08121292 OTHER MACROLIDES 2022-04-01 2024-03-31 Price Change Oral 0 ANTI-INFECTIVE AGENTS 2022-05-05
41 0141HG KLARICID 500MG TAB (ABB/SBI) CLARITHROMYCIN CLARITHROMYCIN KLARICID 10'S C 11.96 1.1961 TAB 14 TAB ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
41 0141HH KLARICID XL 500MG ER TAB (ABB/SBI) CLARITHROMYCIN CLARITHROMYCIN KLARICID XL 10'S C 17.34 1.7343 0 TABE ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 08121292 OTHER MACROLIDES ORAL 0 ANTI-INFECTIVE AGENTS
40 0211Y MEROPENEM 500MG INJ (ABB/PHA) MEROPENEM MEROPENEM 500MG VIAL BQ 11.50 11.50 INJECTION 0 VIAL ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 08120708 CARBAPENEMS 2022-04-01 2024-03-31 IV 6 ANTI-INFECTIVE AGENTS
40 0211Y MEROPENEM 500MG INJ (ABB/PHA) (BQ) MEROPENEM MEROPENEM 500MG VIAL BQ 11.5 11.5 INJECTION ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 8120708 CARBAPENEMS 2022-04-01 2023-03-31 Delete from contract IV 6 CARBAPENEMS 2023-03-02
41 1261L ULTANE (4456-02) (ABB/PHA) SEVOFLURANE SEVOFLURANE ULTANE (4456-02) 250ML BQ 264.74 264.7376 SOLN 30 BOTT ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 280416 INHALATION ANAESTHETICS INHALATION 0 CENTRAL NERVOUS SYSTEM DRUGS
40 1261L ULTANE (4456-02) (ABB/PHA) SEVOFLURANE SEVOFLURANE ULTANE (4456-02) 250ML BQ 265.04 265.04 SOLUTION 0 BOTT ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 280416 INHALATION ANAESTHETICS 2022-04-01 2024-03-31 INHALATION 0 CENTRAL NERVOUS SYSTEM DRUGS
40 2962R POST DAY 1.5MG TAB (ABB/PHA) LEVONORGESTREL LEVONORGESTREL POST DAY 1'S C 9.89 9.89 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 6812 CONTRACEPTIVES 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 2962R POST DAY 1.5MG TAB (ABB/PHA) LEVONORGESTREL (C) LEVONORGESTREL POST DAY 1'S C 9.89 9.89 TABLET IMMED ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 6832 PROGESTINS 2022-04-01 2023-04-13 Delete from contract Oral 0 PROGESTINS 2023-03-02
40 2991Q SYNTHROID 0.1MG TAB (ABB/PHA) THYROXINE THYROXINE SYNTHROID 30'S C 7.75 0.26 TABLET 0 TAB ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 683604 THYROID AGENTS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 2991Q SYNTHROID 0.1MG TAB (ABB/PHA) THYROXINE (C) THYROXINE SYNTHROID 30'S C 7.75 0.2583 TABLET IMMED ABB ABBOTT PHA PHARMACY SALES CARIBBEAN 683604 THYROID AGENTS 2022-04-01 2002-03-31 Delete from contract Oral 0 THYROID AGENTS 2023-03-02
41 2991T SYNTHROID 0.1MG TAB (ABB/SBI) THYROXINE THYROXINE SYNTHROID 30'S C 8.07 0.2691 TAB 60 TAB ABB ABBOTT SBI MASSY DISTRIBUTION (BDOS) LTD 6836 THYROID AGENTS ORAL 6 HORMONES AND SYNTHETIC SUBSTITUTES