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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 2002F SODIUM LACTATE CO. (2B2323Q) INJ (BAX) (B) CALCIUM|CHLORIDE|LACTATE|POTASSIUM|SODIUM SODIUM LACTATE (2B2323Q) 500ML B 5.03 5.0289 BAG 0 BAG BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4008 ALKALINIZING AGENTS 2024-04-01 2026-03-31 IV 0 ALKALINIZING AGENTS