Displaying 1 - 9 of 9
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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 20413 AMINOPLASMAL E 10% SOLN (BRA/COL) AMINO ACID AMINO ACID AMINOPLASMAL E 500ML BQ 15.20 15.20 INJECTION 0 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 20413 AMINOPLASMAL E 10% (BRA) AMINO ACID (BQ) AMINO ACID AMINOPLASMAL E 500ML BQ 16.45 16.4459 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 20413 AMINOPLASMAL E 10% (BRA) AMINO ACID AMINO ACID AMINOPLASMAL E 500ML BQ 24.46 24.46 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4020 CALORIC AGENTS 2026-04-01 2028-03-31 IV 0 CALORIC AGENTS
40 20425 AMINOPLASMAL E 5% SOLN (BRA/COL) AMINO ACID AMINO ACID AMINOPLASMAL E 500ML BQ 13.75 13.75 INJECTION 0 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 20425 AMINOPLASMAL E 5% (BRA) AMINO ACID (BQ) AMINO ACID AMINOPLASMAL E 500ML BQ 14.35 14.3528 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 20425 AMINOPLASMAL E 5% (BRA) AMINO ACID AMINO ACID AMINOPLASMAL E 500ML BQ 19.57 19.57 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4020 CALORIC AGENTS 2026-04-01 2028-03-31 IV 0 CALORIC AGENTS
40 20443 AMINOPLASMAL W | O ELECTROLYTES 15% INJ (BRA/COL) AMINO ACID AMINO ACID AMINOPLASMAL W|O ELECTROLYTES 500ML BQ 26.45 26.45 INJECTION 0 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 20443 AMINOPLASMAL W|O ELECTROLYTES 15% INJ (BRA) AMINO ACID (BQ) AMINO ACID AMINOPLASMAL W|O ELECTROLYTES 500ML BQ 28.19 28.189 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4020 CALORIC AGENTS 2024-04-01 2026-03-31 IV 0 CALORIC AGENTS
42 20443 AMINOPLASMAL W|O ELECTROLYTES 15% INJ (BRA) AMINO ACID AMINO ACID AMINOPLASMAL W|O ELECTROLYTES 500ML BQ 48.93 48.93 BOTT 100 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4020 CALORIC AGENTS 2026-04-01 IV 0 CALORIC AGENTS