Displaying 181 - 200 of 508
| Contract Number | Brand Code | Drug | LAgent Code | Drug Contract Start Date | Drug Contract End Date | Formulary Category | Package Size | Protocol Monthly Max | Package Price | Contract Changed | Change Date | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 40 | 16058 | DIAZEPAM 5MG/ML IV/IM INJ (RTM/PHA) | PHA | 2022-06-01 | 2024-03-31 | B | 10X2ML | 0 | 21.96 | Price Change | 2022-05-31 | ||
| 40 | 4141TV | DICLOFENAC SOD 50MG TAB (HEA/ATB) | ATB | 2022-12-07 | 2024-03-31 | A | 10X10 | 2.64 | Change Local Agent | 2022-11-25 | |||
| 40 | 4144CX | DICLOFENAC SOD SR 100MG TAB (HEA/ATB) | ATB | 2022-12-07 | 2024-03-31 | A | 10X10 | 6.12 | Change Local Agent | 2022-11-25 | |||
| 40 | 4144PA | DICLOFENAC SOD SR 75MG TAB (HEA/ATB) (C) | ATB | 2022-12-07 | 2024-03-31 | C | 10'S | 1.5 | Change Local Agent | 2022-11-25 | |||
| 40 | 2561S | DIMENHYDRINATE 50MG TAB (FSB/ATB) | ATB | 2022-04-01 | 2022-09-30 | A | 10X10 | 180 | 5.08 | 2022-03-30 | |||
| 40 | 2565Y | DIMENHYDRINATE 50MG/ML INJ (LAF/AHI) | AHI | 2022-04-01 | 2024-03-31 | B | 100X1ML | 0 | 142.41 | Change Local Agent | 2022-02-03 | ||
| 40 | 2565T | DIMENHYDRINATE 50MG/ML IV/IM INJ (MON/PHA) | PHA | 2022-04-01 | 2024-03-31 | B | 5ML | 0 | 2.20 | 2021-12-17 | |||
| 41 | A5015 | DIOVAN | A | 14 | 30 | $9.08 | 2024-09-10 | ||||||
| 40 | A501G | DIOVAN 160 MG (NVS/COL) | COL | 2024-03-31 | A | 14'S | 30 | 9.08 | 2023-08-17 | ||||
| 40 | A5026 | DIOVAN 320MG (NVS/COL) | COL | 2024-03-31 | B | 14 | 30 | 9.74 | 2023-08-17 | ||||
| 40 | 3921CQ | DIPYRIDAMOLE 25MG TAB (LDP/AHI) | AHI | 2022-04-01 | 2024-03-31 | BQ | 100'S | 120 | 49.72 | Add to Contract as Cat B | 2022-03-10 | ||
| 40 | 3921CM | DIPYRIDAMOLE 50MG TAB (LDP/AHI) | AHI | 2022-04-01 | 2024-03-31 | BQ | 100'S | 120 | 49.72 | Add to Contract as Cat B | 2022-03-10 | ||
| 40 | 3921CS | DIPYRIDAMOLE 75MG TAB (LDP/AHI) | AHI | 2022-04-01 | 2024-03-31 | BQ | 100'S | 120 | 49.72 | Add to Contract as Cat B | 2022-03-10 | ||
| 40 | 7621BC | DIXI 35 2MG C/35MCG E TAB (ABB/PHA) CYPROTERO (C) | PHA | 2022-04-01 | 2023-03-31 | C | 21'S | 12.07 | Delete from contract | 2023-03-02 | |||
| 40 | 1612A | DOCETAXEL 80MG INJ (EBA/COL) | COL | 2022-04-01 | 2024-03-31 | C | 80MG VIAL | 0 | 68.58 | Price Change | 2022-01-18 | ||
| 40 | B051B | DOLUTEGRAVIR 50MG TAB (APL/ATB) | ATB | 2022-04-12 | 2024-03-31 | BL | 30'S | 0 | 10.66 | Add to Contract as Cat B | 2022-04-12 | ||
| 40 | 4463N | DONEPEZIL 5MG TAB (CIP/AHI) | AHI | 2022-11-29 | 2024-03-31 | A | 4X7'S | 30 | 8.05 | Add to Contract as Cat A | 2022-11-29 | ||
| 40 | A5916 | DOXORUBICIN 50MG SOLN FOR INJ (EBA/COL) | COL | 2022-04-01 | 2024-03-31 | BQ | 50MG VIAL | 0 | 34.93 | Price Change | 2022-01-18 | ||
| 40 | 5521CJ | DOXYCYCLINE 100MG TAB (FSB/ATB) | ATB | 2022-04-01 | 2024-03-31 | A | 3X10 | 14 | 2.85 | Add to Contract as Cat A | 2021-12-03 | ||
| 40 | 5521BV | DOXYCYCLINE 100MG TAB (GPC/ATB) | ATB | 2022-04-01 | 2022-09-30 | A | 100'S | 14 | 6.52 | 2022-03-30 | |||