Displaying 1 - 20 of 26
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
40 37834 DEXTROSE | SODIUM CHLORIDE 5% | 0.2% INJ (BAX/STO) 1 LITRE B 4.62 5%|0.2% 0 2022-04-01 2024-03-31 0
41 37834 DEXTROSE|SODIUM CHLORIDE 5%|0.2% INJ (BAX) (B) 1 LITRE B 7.8288 5%|0.2% 0 2024-04-01 2026-03-31 0
40 37842 DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 250ML B 3.07 5%|0.9% 0 2022-04-01 2024-03-31 0
41 37845 DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (CSC) (B) 250ML B 2.1475 5%|0.9% 100 2024-04-01 2026-03-31 0
40 3785D DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 500ML B 3.34 5%|0.9% 0 2022-04-01 2024-03-31 0
41 3785D DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (BAX) (B) 500ML B 5.0289 5%|0.9% 100 2024-04-01 2026-03-31 0
40 3785G DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 500ML B 2.85 5%|0.9% 0 2022-04-01 2022-06-15 Price Change 0
40 3785G DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 500ML B 3.79 5%|0.9% 0 2022-06-16 2024-03-31 Price Change 0
41 3785G DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (CSC) (B) 500ML B 2.4465 5%|0.9% 100 2024-04-01 2026-03-31 0
40 37862 DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 1 LITRE B 3.18 5%|0.9% 0 2022-04-01 2024-03-31 0
41 37862 DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (BAX) (B) 1 LITRE B 5.5997 5%|0.9% 100 2024-04-01 2026-03-31 0
40 3786F DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 1 LITRE B 3.15 5%|0.9% 0 2022-04-01 2022-06-18 Price Change 0
40 3786F DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 1 LITRE B 4.23 5%|0.9% 0 2022-06-19 2022-07-18 Price Change 0
40 3786F DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 1 LITRE B 4.00 5%|0.9% 0 2022-07-19 2024-03-31 Price Change 0
41 3786F DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (CSC) (B) 1 LITRE B 3.7241 5%|0.9% 100 2024-04-01 2026-03-31 0
40 37882 DEXTROSE | SODIUM CHLORIDE 5% | 0.45% INJ (CSC/PHA) 500ML B 2.50 5%|0.45% 0 2022-04-01 2022-06-15 Price Change 0
40 37882 DEXTROSE | SODIUM CHLORIDE 5% | 0.45% INJ (CSC/PHA) 500ML B 2.80 5%|0.45% 0 2022-06-16 2024-03-31 Price Change 0
41 37882 DEXTROSE|SODIUM CHLORIDE 5%|0.45% INJ (CSC) (B) 500ML B 2.4465 5%|0.45% 50 2024-04-01 2026-03-31 0
40 3788D DEXTROSE | SODIUM CHLORIDE 5% | 0.45% INJ (BAX/STO) 500ML B 2.58 5%|0.45% 0 2022-04-01 2024-03-31 0
41 3788D DEXTROSE|SODIUM CHLORIDE 5%|0.45% INJ (BAX) (B) 500ML B 5.0289 5%|0.45% 50 2024-04-01 2026-03-31 0