Displaying 181 - 200 of 495
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 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
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
40 0013BL DPH ELIXIR 2.5MG/ML SYR (FED/ATB) DIPHENHYDRA ATB 2022-05-11 2024-03-31 A 120ML 120 4.08 Change Local Agent 2022-05-11
40 0013BH DPH ELIXIR 2.5MG/ML SYR (FED/RXP) DIPHENHYDRA RXP 2022-04-01 2022-05-11 A 120ML 120 4.08 Delete from contract 2022-05-11
40 4211BC ECONAZOLE | HYDROCORTISONE 1% | 1% CR (KWA/ATB) ATB 2022-04-01 2022-09-30 A 15G 2 4.08 2022-03-30
40 A322KV EFFEXOR XR 150MG CAP (PFI/SBI) VENLAFAXINE SBI 2022-04-01 2024-03-31 C 14'S 0 67.80 Price Change 2022-04-01
40 A322GA EFFEXOR XR 150MG CAP (PFI/STO) VENLAFAXINE STO 2022-04-01 2022-08-23 C 14'S 0 67.80 Delete from contract 2022-07-12