Displaying 1 - 20 of 23
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 19932 SODIUM CHLORIDE 0.45% INJ (CSC/PHA) 1 LITRE B 4.15 0.45% 0 2022-04-01 2022-06-15 Price Change 0
40 19932 SODIUM CHLORIDE 0.45% INJ (CSC/PHA) 1 LITRE B 5.30 0.45% 0 2022-06-16 2022-07-18 Price Change 0
40 19932 SODIUM CHLORIDE 0.45% INJ (CSC/PHA) 1 LITRE B 3.77 0.45% 0 2022-07-19 2024-03-31 Price Change 0
40 19938 SODIUM CHLORIDE 0.45% INJ (BAX/STO) 1 LITRE B 4.76 0.45% 0 2022-04-01 2024-03-31 0
40 19944 SODIUM CHLORIDE 0.45% INJ (CSC/PHA) 500ML B 3.50 0.45% 0 2022-04-01 2022-06-15 Price Change 0
40 19944 SODIUM CHLORIDE 0.45% INJ (CSC/PHA) 500ML B 4.48 0.45% 0 2022-06-16 2024-03-31 Price Change 0
40 1994D SODIUM CHLORIDE (2B1313Q) 0.45% INJ (BAX/STO) 500ML B 5.00 0.45% 0 2022-04-01 2024-03-31 0
40 19952 SODIUM CHLORIDE (2B1322Q) 0.9% INJ (BAX/STO) 250ML B 2.09 0.9% 0 2022-04-01 2024-03-31 0
40 19958 SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 250ML B 2.10 0.9% 0 2022-04-01 2022-06-15 Price Change 0
40 19958 SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 250ML B 2.64 0.9% 0 2022-06-16 2022-07-18 Price Change 0
40 19958 SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 250ML B 2.09 0.9% 0 2022-07-19 2024-03-31 Price Change 0
40 19968 SODIUM CHLORIDE (2B1323Q) 0.9% INJ (BAX/STO) 500ML B 2.58 0.9% 0 2022-04-01 2024-03-31 0
40 1996H SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 500ML B 2.40 0.9% 0 2022-04-01 2022-06-15 Price Change 0
40 1996H SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 500ML B 3.22 0.9% 0 2022-06-16 2022-07-27 Price Change 0
40 1996H SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 500ML B 2.53 0.9% 0 2022-07-19 2024-03-31 Price Change 0
40 19972 SODIUM CHLORIDE (2B1324X) 0.9% INJ (BAX/STO) 1 LITRE B 2.96 0.9% 0 2022-04-01 2024-03-31 0
40 1997E SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 1 LITRE B 2.85 0.9% 0 2022-04-01 2022-06-15 Price Change 0
40 1997E SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 1 LITRE B 4.82 0.9% 0 2022-06-16 2022-07-18 Price Change 0
40 1997E SODIUM CHLORIDE 0.9% INJ (CSC/PHA) 1 LITRE B 3.79 0.9% 0 2022-07-19 2024-03-31 Price Change 0
40 19985 SODIUM CHLORIDE 0.9% INJ (BRA/COL) 20X10ML B 1.41 0.9% 0 2022-04-01 2024-03-31 0