Browse by Standard Packs

Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits

Item code Drug name
Form and Strength
Pack size Price Manufacturer
13801J BENZATHINE BENZYLPENICILLINbenzathine benzylpenicillin 1.2 million units powder for injection [1 vial] (&) inert substance diluent [5 mL vial], 1 pack 1 $50.33 YO
3486L BENZYLPENICILLINbenzylpenicillin 600 mg injection, 1 vial 1 $6.90 CS
3463G DIPHTHERIA + TETANUS VACCINEdiphtheria 2 units + tetanus 20 units vaccine injection, 5 x 0.5 mL syringes 5 $64.32 CS
3470P HYDROCORTISONE SODIUM SUCCINATEhydrocortisone (as sodium succinate) 100 mg injection [1 chamber] (&) inert substance diluent [2 mL chamber], 1 dual chamber vial 1 $7.30 PF
13144T MOLNUPIRAVIRmolnupiravir 200 mg capsule, 40 40 $1092.04 MK
10786Q NALOXONEnaloxone hydrochloride 400 microgram/mL injection, 5 x 1 mL ampoules 5 $24.51 JU,PF,XN
13147Y NIRMATRELVIR (&) RITONAVIRnirmatrelvir 150 mg tablet [4] (&) ritonavir 100 mg tablet [2], 5 x 6 1 $1104.04 PF
3488N PROMETHAZINEpromethazine hydrochloride 50 mg/2 mL injection, 5 x 2 mL ampoules 5 $13.99 PF