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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 28818 WATER FOR INJ INJ (BRA/COL) STERILE WATER WATER FOR INJ 100ML B 1.82 1.82 INJECTION 0 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4036 IRRIGATING SOLUTIONS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 28818 WATER FOR INJ (BRA) (B) STERILE WATER WATER FOR INJ 100ML B 2.04 2.0387 BOTT 20 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4036 IRRIGATING SOLUTIONS 2024-04-01 2026-03-31 IV 0 IRRIGATING SOLUTIONS
42 28818 WATER FOR INJ INJ (BRA) STERILE WATER STERILE WATER WATER FOR INJ 100ML B 3.86 3.86 BOTT 20 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4036 IRRIGATING SOLUTIONS 2026-04-01 IV 0 IRRIGATING SOLUTIONS
41 28831 WATER FOR INJ (BRA) STERILE WATER WATER FOR INJ 1 LITRE B 3.75 3.7513 BOTT 20 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4036 IRRIGATING SOLUTIONS 2024-04-01 2026-03-31 IV 0 IRRIGATING SOLUTIONS
42 28831 WATER FOR INJ INJ (BRA) STERILE WATER STERILE WATER WATER FOR INJ 1 LITRE B 6.52 6.52 BOTT 20 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4036 IRRIGATING SOLUTIONS 2026-04-01 IV 0 IRRIGATING SOLUTIONS
40 2883A WATER FOR INJ INJ (BAX/STO) STERILE WATER STERILE WATER WATER FOR INJ 1 LITRE B 5.55 5.55 INJECTION 0 BOTT BAX BAXTER EXPORT CORP. STO BRYDEN STOKES LTD 4036 IRRIGATING SOLUTIONS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
40 28853 WATER FOR INJ (BRA/COL) STERILE WATER STERILE WATER WATER FOR INJ 20X10ML B 15.63 0.78 INJECTION 0 VIAL BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4036 IRRIGATING SOLUTIONS 2022-04-01 2024-03-31 IV 0 ELECTROLYTIC, CALORIC, AND WATER BALANCE
41 28853 WATER FOR INJ (BRA) STERILE WATER STERILE WATER WATER FOR INJ 20X10ML B 7.8 0.3901 VIAL 20 BOX BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL COLLINS LTD 4036 IRRIGATING SOLUTIONS 2024-04-01 2026-03-31 IV 0 IRRIGATING SOLUTIONS
42 28853 WATER FOR INJ (BRA) STERILE WATER STERILE WATER WATER FOR INJ 20X10ML B 14.35 0.72 VIAL 20 BOTT BRA B. BRAUN MELSUNGEN AG CARL-BRAUN-STRABE COL AVENTA BARBADOS 4036 IRRIGATING SOLUTIONS 2026-04-01 IV 0 IRRIGATING SOLUTIONS