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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 20116 POTASSIUM CHLORIDE 600MG TAB (KWA/ATB) POTASSIUM CHLORIDE POTASSIUM CHLORIDE 10X10 A 62.52 0.63 TABLET 120 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 4012 REPLACEMENT THERAPY 2022-04-01 2024-03-31 Oral 6 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 20117 POTASSIUM CHLORIDE 600MG SR TAB (LDP) POTASSIUM CHLORIDE POTASSIUM 100'S A 59.67 0.5967 TABSR 120 BOX LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2024-04-01 2026-03-31 ORAL 6 REPLACEMENT THERAPY
42 20117 POTASSIUM CHLORIDE 600MG SR TAB (LDP) POTASSIUM CHLORIDE POTASSIUM CHLORIDE 100'S A 59.67 0.60 TAB 120 BLIS LDP LABDHI PHARMA AHI ARMSTRONG HEALTHCARE INC 4012 REPLACEMENT THERAPY 2026-04-01 ORAL 6 REPLACEMENT THERAPY
40 2012L POTASSIUM CHLORIDE 2MEQ/ML INJ (BRA/COL) POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20X10ML B 13.08 0.65 INJECTION 0 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4012 REPLACEMENT THERAPY 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 2012L POTASSIUM CHLORIDE 2MEQ/ML INJ (BRA) (B) POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20X10ML B 13.08 0.6538 VIAL 0 BOX BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4012 REPLACEMENT THERAPY 2024-04-01 2026-03-31 IV 0 REPLACEMENT THERAPY
42 2012L POTASSIUM CHLORIDE 2MEQ/ML INJ (BRA) POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20X10ML B 31.32 1.57 VIAL 0 AMP BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4012 REPLACEMENT THERAPY 2026-04-01 IV 0 REPLACEMENT THERAPY
42 2012V POTASSIUM CHLORIDE 2MEQ/ML INJ (MON POTASSIUM CHLORIDE POTASSIUM CHLORIDE 5X10ML B 7.50 1.50 AMPG 0 AMP MON MONTAGE PHARMACEUTICALS PHA PHARMACY SALES CARIBBEAN 4012 REPLACEMENT THERAPY 2026-04-01 IV 0 REPLACEMENT THERAPY
41 2012X POTASSIUM CHLORIDE 2MEQ/ML INJ (FSB) (B) POTASSIUM CHLORIDE POTASSIUM 5X10ML B 5.71 1.142 AMP 0 BOX FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD 4012 REPLACEMENT THERAPY 2024-04-01 2026-03-31 0 REPLACEMENT THERAPY 2024-01-26
40 5062AJ REHYDRATION SALTS (HEA/ATB) GLUCOSE|POTASSIUM CHLORIDE|SODIUM CHLORIDE|SODIUM CITRATE REHYDRATION SALTS 30'S A 18.62 0.6207 SACHET HEA HEALTH 2000 INC ATB ANSA TRADING BARBADOS LTD 4012 REPLACEMENT THERAPY 2022-12-07 2024-03-31 Change Local Agent ORAL 0 REPLACEMENT THERAPY 2022-11-25