Displaying 1 - 5 of 5
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 20116 POTASSIUM CHLORIDE 600MG TAB (KWA/ATB) 10X10 A 0.63 600MG 120 2022-04-01 2024-03-31 6
41 20117 POTASSIUM CHLORIDE 600MG SR TAB (LDP) 100'S A 0.5967 600MG 120 2024-04-01 2026-03-31 6
40 2012L POTASSIUM CHLORIDE 2MEQ/ML INJ (BRA/COL) 20X10ML B 0.65 2MEQ/ML 0 2022-04-01 2024-03-31 0
41 2012L POTASSIUM CHLORIDE 2MEQ/ML INJ (BRA) (B) 20X10ML B 0.6538 2MEQ/ML 0 2024-04-01 2026-03-31 0
41 2012X POTASSIUM CHLORIDE 2MEQ/ML INJ (FSB) (B) 5X10ML B 1.142 2MEQ/ML 0 2024-04-01 2026-03-31 0