Browse by Standard Packs
Standard Packs and Prices for Ready Prepared Pharmaceutical Benefits
| Item code | Drug name Form and Strength |
Pack size | Price | Manufacturer |
|---|---|---|---|---|
| 14183L | ALFUZOSINalfuzosin hydrochloride 10 mg modified release tablet, 30 | 30 | $66.70 | SW |
| 4579B | ALPROSTADILalprostadil 10 microgram injection [1 chamber] (&) inert substance diluent [0.5 mL chamber], 2 dual chamber syringes | 2 | $37.37 | PF |
| 4580C | ALPROSTADILalprostadil 20 microgram injection [1 chamber] (&) inert substance diluent [0.5 mL chamber], 2 dual chamber syringes | 2 | $48.14 | PF |
| 4598B | BANDAGE COMPRESSIONbandage compression four layer bandage, 1 | 1 | $41.40 | SN |
| 4658E | BANDAGE COMPRESSIONbandage compression four layer bandage, 1 | 1 | $62.70 | SN |
| 4748X | BANDAGE COMPRESSIONbandage compression 10 cm x 3 m high stretch bandage, 1 | 1 | $13.07 | CC |
| 4748X | BANDAGE COMPRESSIONbandage compression 10 cm x 3 m high stretch bandage, 1 | 1 | $29.12 | BV |
| 4657D | BANDAGE COMPRESSIONbandage compression 10 cm x 3.5 m high stretch bandage, 1 | 1 | $14.10 | MH |
| 4654Y | BANDAGE COMPRESSIONbandage compression 8 cm x 2.6 m short stretch bandage, 1 | 1 | $14.14 | BV |
| 4814J | BANDAGE RETENTION COHESIVE HEAVYbandage retention cohesive heavy 15 cm x 1.3 m bandage, 1 | 1 | $11.92 | MM |
| 4811F | BANDAGE RETENTION COHESIVE HEAVYbandage retention cohesive heavy 5 cm x 1.3 m bandage, 1 | 1 | $5.76 | MM |
| 4812G | BANDAGE RETENTION COHESIVE HEAVYbandage retention cohesive heavy 7.5 cm x 1.3 m bandage, 1 | 1 | $7.19 | MM |
| 4813H | BANDAGE RETENTION COHESIVE HEAVYbandage retention cohesive heavy 10 cm x 1.3 m bandage, 1 | 1 | $8.83 | MM |
| 4660G | BANDAGE RETENTION COHESIVE HEAVYbandage retention cohesive heavy 10 cm x 2 m bandage, 1 | 1 | $8.09 | MM |
| 4662J | BANDAGE RETENTION COHESIVE LIGHTbandage retention cohesive light 10 cm x 2 m bandage, 1 | 1 | $13.65 | BV |
| 4719J | BANDAGE RETENTION COHESIVE LIGHTbandage retention cohesive light 6 cm x 2 m bandage, 1 | 1 | $6.72 | BV |
| 4729X | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 10 cm x 2.3 m bandage, 1 | 1 | $10.70 | KE |
| 4729X | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 10 cm x 2.3 m bandage, 1 | 1 | $13.42 | BV |
| 4727T | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 5 cm x 2.3 m bandage, 1 | 1 | $7.24 | KE |
| 4727T | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 5 cm x 2.3 m bandage, 1 | 1 | $8.57 | BV |
| 4728W | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 7.5 cm x 2.3 m bandage, 1 | 1 | $9.33 | KE |
| 4728W | BANDAGE RETENTION COTTON CREPEbandage retention cotton crepe 7.5 cm x 2.3 m bandage, 1 | 1 | $10.85 | BV |
| 4799N | BANDAGE TUBULAR LONG STOCKINGbandage tubular long stocking large size bandage, 1 | 1 | $15.81 | MH |
| 4797L | BANDAGE TUBULAR LONG STOCKINGbandage tubular long stocking medium size bandage, 1 | 1 | $15.81 | MH |
| 4674B | BANDAGE TUBULAR LONG STOCKINGbandage tubular long stocking small size bandage, 1 | 1 | $15.81 | MH |
| 4675C | BANDAGE TUBULAR LONG STOCKINGbandage tubular long stocking XX/large size bandage, 1 | 1 | $15.82 | MH |
| 4816L | BANDAGE TUBULAR SHORT STOCKINGbandage tubular short stocking large D/E size bandage, 1 | 1 | $10.70 | MH |
| 4815K | BANDAGE TUBULAR SHORT STOCKINGbandage tubular short stocking medium C/D size bandage, 1 | 1 | $10.70 | MH |
| 4661H | BANDAGE TUBULAR SHORT STOCKINGbandage tubular short stocking small B/C size bandage, 1 | 1 | $10.70 | MH |
| 4669R | BANDAGE ZINC PASTEbandage zinc paste 7.5 cm x 6 m bandage, 1 | 1 | $12.56 | MH |
| 4750B | BANDAGE ZINC PASTEbandage zinc paste 7.5 cm x 6 m bandage, 1 | 1 | $46.67 | SN |
| 10578R | BISACODYLbisacodyl 10 mg suppository, 10 | 1 | $6.28 | VZ |
| 10578R | BISACODYLbisacodyl 10 mg suppository, 10 | 1 | $5.85 | PP |
| 14567Q | BISACODYLbisacodyl 10 mg suppository, 10 | 1 | $5.46 | VZ |
| 14567Q | BISACODYLbisacodyl 10 mg suppository, 10 | 1 | $5.03 | PP |
| 10580W | BISACODYLbisacodyl 10 mg suppository, 12 | 1 | $5.40 | PP |
| 14572Y | BISACODYLbisacodyl 10 mg suppository, 12 | 1 | $4.58 | PP |
| 4150K | BROMAZEPAMbromazepam 3 mg tablet, 30 | 30 | $12.49 | PB |
| 4151L | BROMAZEPAMbromazepam 6 mg tablet, 30 | 30 | $15.36 | PB |
| 14174B | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $9.35 | PP |
| 14174B | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $8.03 | CR |
| 14175C | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $8.12 | PP |
| 14175C | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $6.80 | CR |
| 4142B | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $9.35 | PP |
| 4142B | CALCIUMcalcium carbonate 1.5 g (calcium 600 mg) tablet, 120 | 120 | $8.03 | CR |
| 11845K | CALCIUMcalcium carbonate 1.25 g (calcium 500 mg) chewable tablet, 120 | 120 | $10.50 | PP |
| 14176D | CALCIUMcalcium carbonate 1.25 g (calcium 500 mg) chewable tablet, 120 | 120 | $10.50 | PP |
| 14217G | CALCIUMcalcium carbonate 1.25 g (calcium 500 mg) chewable tablet, 120 | 120 | $9.27 | PP |
| 4681J | DRESSING ACTIVATED CHARCOAL MALODOROUS WOUNDdressing activated charcoal malodorous wound 10.5 cm x 10.5 cm dressing, 1 | 1 | $9.08 | KI |
| 4832H | DRESSING ALGINATE CAVITY WOUNDdressing alginate cavity wound 2 g rope, 1 | 1 | $9.83 | UM |
| 1905G | DRESSING ALGINATE CAVITY WOUNDdressing alginate cavity wound 2 g rope, 5 x 2 g | 5 | $51.93 | CC |
| 4682K | DRESSING ALGINATE CAVITY WOUNDdressing alginate cavity wound 2 g (40 cm) rope, 6 x 2 g | 1 | $62.62 | CT |
| 4831G | DRESSING ALGINATE SUPERFICIAL WOUNDdressing alginate superficial wound 10 cm x 10 cm dressing, 1 | 1 | $8.10 | CT |
| 4831G | DRESSING ALGINATE SUPERFICIAL WOUNDdressing alginate superficial wound 10 cm x 10 cm dressing, 1 | 1 | $7.58 | UM |
| 4684M | DRESSING ALGINATE SUPERFICIAL WOUNDdressing alginate superficial wound 5 cm x 5 cm dressing, 1 | 1 | $4.09 | CT |
| 4688R | DRESSING FILMdressing film 15 cm x 20 cm dressing, 1 | 1 | $4.33 | MM |
| 4689T | DRESSING FILM ISLANDdressing film island 5 cm x 7 cm dressing, 1 | 1 | $1.34 | MM |
| 4690W | DRESSING FILM ISLANDdressing film island 9 cm x 10 cm dressing, 1 | 1 | $2.34 | MM |
| 4898T | DRESSING FILM ISLANDdressing film island 5 cm x 7.2 cm dressing, 5 | 1 | $14.44 | SN |
| 4899W | DRESSING FILM ISLANDdressing film island 8 cm x 10 cm dressing, 5 | 1 | $23.65 | SN |
| 2445Q | DRESSING GELLING FIBREdressing gelling fibre 15 cm x 15 cm dressing, 5 | 1 | $129.64 | SN |
| 4906F | DRESSING HYDROACTIVE SUPERFICIAL WOUND LIGHT EXUDATEdressing hydroactive superficial wound light exudate 10 cm x 10 cm dressing, 5 | 1 | $72.18 | SN |
| 4886E | DRESSING HYDROACTIVE SUPERFICIAL WOUND MODERATE EXUDATEdressing hydroactive superficial wound moderate exudate 10 cm x 10 cm dressing, 5 | 1 | $45.97 | SN |
| 4896Q | DRESSING HYDROCOLLOID CAVITY WOUNDdressing hydrocolloid cavity wound paste, 30 g | 1 | $13.23 | CC |
| 4679G | DRESSING HYDROCOLLOID SUPERFICIAL WOUND MODERATE EXUDATEdressing hydrocolloid superficial wound moderate exudate 10cm (round) dressing, 1 | 1 | $10.65 | CT |
| 4897R | DRESSING HYDROCOLLOID SUPERFICIAL WOUND MODERATE EXUDATEdressing hydrocolloid superficial wound moderate exudate 10 cm x 10 cm dressing, 5 | 1 | $36.54 | CC |
| 4678F | DRESSING HYDROCOLLOID SUPERFICIAL WOUND MODERATE EXUDATEdressing hydrocolloid superficial wound moderate exudate 7cm (butterfly shape) dressing, 1 | 1 | $9.83 | CT |
| 4920Y | DRESSING HYDROCOLLOID SUPERFICIAL WOUND MODERATE EXUDATEdressing hydrocolloid superficial wound moderate exudate 20 cm x 20 cm dressing, 5 | 1 | $103.85 | CC |
| 2803M | DRESSING HYDROFIBRE ALTERNATE TO ALGINATESdressing hydrofibre alternate to alginates 15 cm x 15 cm dressing, 5 | 1 | $96.70 | CC |
| 4894N | DRESSING HYDROGEL AMORPHOUSdressing hydrogel amorphous gel, 25 g | 1 | $20.45 | SN |
| 4599C | DRESSING HYDROGEL AMORPHOUSdressing hydrogel amorphous gel, 50 g | 1 | $11.64 | SN |
| 4914P | DRESSING HYDROGEL AMORPHOUSdressing hydrogel amorphous gel, 50 g | 1 | $9.38 | JJ |
| 4913N | DRESSING HYDROGEL AMORPHOUSdressing hydrogel amorphous gel, 3 x 30 g | 1 | $29.12 | CC |
| 4806Y | DRESSING HYDROGEL SHEETdressing hydrogel sheet 10 cm x 10 cm dressing, 5 | 1 | $23.64 | HR |
| 4911L | DRESSING HYDROGEL SHEETdressing hydrogel sheet 9.5 cm x 10.2 cm dressing, 5 | 1 | $37.36 | KI |
| 4862X | DRESSING NON ADHERENTdressing non adherent 10 cm x 10 cm dressing, 5 | 1 | $12.49 | SN |
| 4819P | DRESSING NON ADHERENTdressing non adherent 5 cm x 5 cm dressing, 5 | 1 | $7.41 | SN |
| 4860T | DRESSING NON ADHERENTdressing non adherent 5 cm x 5 cm dressing, 5 | 1 | $8.27 | SN |
| 4909J | DRESSING TULLE NON-ADHERENT PRIMARY WOUND CONTACT LAYER PARAFFINdressing tulle non-adherent primary wound contact layer paraffin 7.6 cm x 7.6 cm dressing, 1 | 1 | $1.30 | KI |
| 14210X | DUTASTERIDEdutasteride 500 microgram capsule, 30 | 30 | $18.82 | TX |
| 14210X | DUTASTERIDEdutasteride 500 microgram capsule, 30 | 30 | $25.82 | GK |
| 14184M | DUTASTERIDE + TAMSULOSINdutasteride 500 microgram + tamsulosin hydrochloride 400 microgram modified release capsule, 30 | 30 | $23.86 | GK |
| 4237B | FEXOFENADINEfexofenadine hydrochloride 60 mg tablet, 20 | 20 | $16.33 | SW |
| 14191X | FINASTERIDEfinasteride 5 mg tablet, 28 | 28 | $80.94 | RZ |
| 14199H | FINASTERIDEfinasteride 5 mg tablet, 30 | 30 | $91.29 | CR,GN,OQ,SZ,TX |
| 14199H | FINASTERIDEfinasteride 5 mg tablet, 30 | 30 | $67.98 | AF,AL,GQ |
| 14199H | FINASTERIDEfinasteride 5 mg tablet, 30 | 30 | $86.73 | RW |
| 10573L | FOLIC ACIDfolic acid 5 mg tablet, 100 | 100 | $5.60 | AF |
| 10584C | FOLIC ACIDfolic acid 500 microgram tablet, 100 | 100 | $4.56 | AF,PP |
| 10596Q | GLYCEROLglycerol 1.4 g suppository, 12 | 1 | $5.72 | PP |
| 4246L | GLYCEROLglycerol 2.8 g suppository, 12 | 1 | $5.88 | PP |
| 10586E | GLYCEROLglycerol 700 mg suppository, 12 | 1 | $5.60 | PP |
| 10598T | PARACETAMOLparacetamol 665 mg modified release tablet, 96 | 96 | $6.22 | CR,GQ,HQ,XT |
| 10585D | PARACETAMOLparacetamol 500 mg tablet, 100 | 100 | $3.31 | BG,OW,QS,SI,SW,SZ,TX,XT |
| 11401C | PROTEIN FORMULA WITH ARGININE, VITAMIN C, E AND ZINCprotein formula with arginine, vitamin C, E and zinc oral liquid, 24 x 200 mL bottles | 1 | $99.39 | SB |
| 14197F | RISEDRONATErisedronate sodium 35 mg tablet, 4 | 4 | $22.88 | SZ,TX |
| 14198G | RISEDRONATErisedronate sodium 35 mg enteric tablet, 4 | 4 | $22.88 | TT |
| 14209W | RISEDRONATErisedronate sodium 5 mg tablet, 28 | 28 | $26.47 | TT |
| 14185N | SILODOSINsilodosin 4 mg capsule, 30 | 30 | $29.25 | YN |
| 14192Y | SILODOSINsilodosin 8 mg capsule, 30 | 30 | $34.00 | YN |
| 14200J | TAMSULOSINtamsulosin hydrochloride 400 microgram modified release tablet, 30 | 30 | $54.30 | AF,BG,GQ,IB,LS,SZ,TX |
| 14182K | THIAMINEthiamine hydrochloride 100 mg tablet, 100 | 100 | $6.35 | PP |
