Browse by Standard Packs

Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits

Item code Drug name
Form and Strength
Pack size Price Manufacturer
3486L BENZYLPENICILLINbenzylpenicillin 600 mg injection, 1 vial 1 $6.80 CS
3463G DIPHTHERIA + TETANUS VACCINEdiphtheria 2 units + tetanus 20 units vaccine injection, 5 x 0.5 mL syringes 5 $61.02 CS
3470P HYDROCORTISONE SODIUM SUCCINATEhydrocortisone (as sodium succinate) 100 mg injection [1 chamber] (&) inert substance diluent [2 mL chamber], 1 dual chamber vial 1 $7.06 PF
13144T MOLNUPIRAVIRmolnupiravir 200 mg capsule, 40 40 $1091.80 MK
10786Q NALOXONEnaloxone hydrochloride 400 microgram/mL injection, 5 x 1 mL ampoules 5 $29.33 JU,PF,XN
13147Y NIRMATRELVIR (&) RITONAVIRnirmatrelvir 150 mg tablet [4] (&) ritonavir 100 mg tablet [2], 5 x 6 1 $1103.80 HD
3488N PROMETHAZINEpromethazine hydrochloride 50 mg/2 mL injection, 5 x 2 mL ampoules 5 $13.95 PF