Drugs available on Contract - [SODIUM CHLORIDE 3% INJ (BAX)], []

Contract Number	42
Brand Code	199E1
Brand Name	SODIUM CHLORIDE 3% INJ (BAX)
Active Ingredient	SODIUM CHLORIDE
Trade Name	SODIUM CHLORIDE
Package Size	500ML
Formulary Category	B
Pkg Price	11.47
Unit Price	11.47
Strength	3%
Unit Description	BAG
Max. Reimbursable Quantity / Month	0
Package Description	BAG
Manufacturer Code	BAX
Manufacturer Name	BAXTER EXPORT CORP.
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	4012
Therapeutic Desc	REPLACEMENT THERAPY
Status Description
Default Route	IV
Max Repeats	0
Therapeutic Head	REPLACEMENT THERAPY
Amend Date