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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 19415 MEDI-TEST COMBI 10 STRP (SCN/PHA) DIAGNOSTIC URINE DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 15.22 15.22 STRIP 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2022-04-01 2022-07-18 0 DIAGNOSTIC AGENTS
40 19415 MEDI-TEST COMBI 10 STRP (SCN/PHA) DIAGNOSTIC URINE DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 20.44 20.44 STRIP 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2022-07-19 2024-03-31 Price Change 0 DIAGNOSTIC AGENTS 2022-07-18
41 19415 MEDI-TEST COMBI 10 STRP (SCN) DIAGNOSTIC URINE (B) DIAGNOSTIC URINE MEDI-TEST COMBI 10 100'S B 25.1 25.1 BOTT 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2024-04-01 2026-03-31 0 URINE CONTENTS 2023-10-05
40 1941G MEDI-TEST COMBI-10 STRP (SCN/PHA) DIAGNOSTIC URINE DIAGNOSTIC URINE MEDI-TEST COMBI-10 50'S B 15.22 15.22 STRIP 0 BOTT SCN SCANPHARM A/S PHA PHARMACY SALES CARIBBEAN 3688 URINE CONTENTS 2022-04-01 2024-03-31 0 DIAGNOSTIC AGENTS