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 3582B SODIUM BICARBONATE 8.4% INJ (BRA/COL) 100ML B 6.50 8.4% 0 2022-04-01 2024-03-31 0
41 3582B SODIUM BICARBONATE 8.4% INJ (BRA) (B) 100ML B 6.9589 8.4% 70 2024-04-01 2026-03-31 0
41 3582F SODIUM BICARBONATE 8.4% INJ (KWA) (B) 50ML B 4.4037 8.4% 70 2024-04-01 2026-03-31 0
40 35831 SODIUM BICARBONATE 8.4% INJ (FSB/ATB) 10ML B 1.14 8.4% 0 2022-04-01 2024-03-31 0
41 35831 SODIUM BICARBONATE 8.4% INJ (FSB) 10ML B 1.1961 8.4% 70 2024-04-01 2026-03-31 0