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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 01243 OPTOMYCIN 0.5% EYE DR (ASL/PHA) CHLORAMPHENIC CHLORAMPHENICOL OPTOMYCIN 10ML C $4.08 $4.08 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 03248 GENOPTIC 0.3% EYE DR (ASL/PHA) GENTAMICIN GENTAMICIN GENOPTIC 5ML BQ $4.08 $4.08 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 0531V IMURAN 50MG TAB (ASG/STO) AZATHIOPRINE AZATHIOPRINE IMURAN 100'S C $174.27 $1.74 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 0 ANTINEOPLASTICS
40 05752 ENDOXAN 1G INJ (ASM/COL) CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE ENDOXAN 1G VIAL BQ $38.06 $38.06 INJECTION 0 VIAL ASM ASTA MEDICA AG COL COLLINS LTD 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 IV 0 ANTINEOPLASTICS
40 0621C PURINETHOL 50MG TAB (ASG/STO) MERCAPTOPURINE MERCAPTOPURINE PURINETHOL 25'S A $104.38 $4.18 TABLET 60 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 1000 ANTINEOPLASTICS 2022-04-01 2024-03-31 Oral 6 ANTINEOPLASTICS
40 07141 ATROPINE SULPHATE 1% EYE DR (ASL/PHA) ATROPINE SULPHATE ATROPINE SULPHATE 10ML A $11.66 $11.66 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5224 EENT MYDRIATICS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 1171V ALDOMET 250MG TAB (ASG/STO) METHYLDOPA METHYLDOPA ALDOMET 30'S A $5.44 $0.18 TABLET 180 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 1172K ALDOMET 500MG TAB (ASG/STO) METHYLDOPA METHYLDOPA ALDOMET 30'S A $8.83 $0.29 TABLET 180 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD B 240816 CENTRAL ALPHA ANTAGONIST 2022-04-01 2024-03-31 Oral 6 CARDIOVASCULAR DRUGS
40 22411 FRAMOPTIC D EYE DR (ASL/PHA) DEX/FRAMY/GRAMI DEXAMETHASONE|FRAMYCETIN|GRAMICIDIN FRAMOPTIC D 10ML C $8.07 $8.07 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 2411B HYPROMELLOSE 0.3% EYE DR (ASL/PHA) HYPROMELLOSE HYPROMELLOSE 10ML A $3.75 $3.75 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5292 EENT DRUGS MISCELLANEOPUS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 2791D OVESTIN 1MG VAG CR (ASP/STO) ESTRIOL ESTRIOL OVESTIN 15G A $41.59 $41.59 VAGINAL CREA 1 TUBE ASP ASTRAPIN, PHARMA GMBH & CO. HG STO BRYDEN STOKES LTD 681604 ESTROGENS 2022-04-01 2024-03-31 Add to Contract as Cat A Vaginal 6 HORMONES AND SYNTHETIC SUBSTITUTES 2021-12-06
40 3571ZV ZYLOPRIM 100MG TAB (ASG/STO) ALLOPURINOL ALLOPURINOL ZYLOPRIM 50'S C $27.18 $0.54 TABLET 0 TAB ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 4040 URICOSURIC AGENTS 2022-04-01 2024-03-31 Oral 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
40 40613 ALLEREX 0.05% | 0.04% EYE DR (ASL/PHA) ANTAZOLI ANTAZOLINE|TETRAHYDROZOLINE ALLEREX 10ML A $5.79 $5.79 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5232 EENT VASOCONSTRICTORS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 6302AQ NIMBEX 2MG/ML INJ (ASG/STO) CISATRACURIUM CISATRACURIUM NIMBEX 5X5ML BQ $114.17 $22.83 INJECTION 0 VIAL ASG ASPEN OSD (GLOBAL) STO BRYDEN STOKES LTD 122020 NEUROMUSCULAR BLOCKING AGENTS 2022-04-01 2024-03-31 IV 0 AUTONOMIC DRUGS
40 6451M MAXISPORIN 1MG/ML | 3MG EYE DR (ASL/PHA) DEXAMETHASONE | NEOMYCIN | POLYMYXIN B DEXAMETHASONE|NEOMYCIN|POLYMYXIN B MAXISPORIN 5ML BQ $5.52 $5.52 EYE DROP 0 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 A7318 ELEVE 0.1% EYE DR (ASL/PHA) OLOPATADINE OLOPATADINE ELEVE 5ML A $6.96 $6.96 EYE DROP 1 BOTT ASL ASHFORD LABORATORIES LTD PHA PHARMACY SALES CARIBBEAN 5202 ANTIALLERGIC AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS