Displaying 241 - 260 of 948
| 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 | 0451BS | CO-TRIMOXAZOLE 400MG|80MG TAB (HEA/ATB) SULFA | ATB | 2022-12-07 | 2024-03-31 | A | 10X10 | 7.2 | Change Local Agent | 2022-11-25 | |||
| 40 | A6812 | COMBIVIR 150MG | 300MG TAB (GSK/COL) LAMIVUDINE | ZIDOVUDINE | COL | 2022-04-01 | 2022-05-31 | BL | 60'S | 0 | 135.02 | Delete from contract | 2022-04-19 | ||
| 40 | A3937 | COMBIWAVE 125/25 INHR (GLP/ALI) FLUTICASONE/S | ALI | 2022-04-01 | 2022-03-22 | C | 120 DOSES | 0 | 27.18 | Delete from contract | 2022-03-22 | ||
| 40 | A393D | COMBIWAVE 125MCG | 25M INHR (GLP/ATB) FLUTICASONE | SALMETEROL | ATB | 2022-04-01 | 2024-03-31 | C | 120 DOSES | 0 | 27.18 | Change Local Agent | 2022-03-22 | ||
| 40 | A396D | Combiwave 250/25 MCG INHR(GLP/AHI) | AHI | 2023-08-15 | 2024-03-31 | A | 150 DOSES | 0 | $32.62 | LOCAL AGENT CHANGED | 2023-12-11 | ||
| 40 | A3965 | COMBIWAVE 250MCG | 25MCG INHR (GLP/ALI) FLUTICASONE | SALMETEROL | ALI | 2022-04-01 | 2022-03-22 | C | 150 DOSES | 0 | 32.62 | Delete from contract | 2022-03-22 | ||
| 40 | A396C | COMBIWAVE 250MCG | 25MCG INHR (GLP/ATB) FLUTICASONE | SALMETEROL | ATB | 2022-04-01 | 2023-09-30 | C | 150 DOSES | 0 | 32.62 | Change Local Agent | 2022-03-22 | ||
| 41 | 17231 | CONCERTA 18MG ER TAB (JAC) METHYLP (C) | STO | 2024-04-01 | 2024-06-20 | C | 30'S | 42 | 130.43 | 2024-06-18 | |||
| 41 | 17231 | CONCERTA 18MG ER TAB (JAC) METHYLP (C) | STO | 2024-08-01 | 2024-12-31 | C | 30'S | 42 | 130.43 | 2024-08-01 | |||
| 41 | 17231 | CONCERTA 18MG ER TAB (JAC) METHYLPHENIDATE | STO | 2024-06-21 | 2024-07-31 | A | 30'S | 30 | 130.43 | 2024-06-18 | |||
| 41 | 17231 | CONCERTA 18MG ER TAB (JAC) METHYLPHENIDATE | STO | 2025-01-01 | 2025-01-31 | A | 30'S | 30 | 130.43 | 2024-12-31 | |||
| 41 | 17241 | CONCERTA 27MG ER TAB (JAC) METHYLP (C) | STO | 2024-04-01 | 2024-06-20 | C | 30'S | 42 | 156.82 | 2024-06-18 | |||
| 41 | 17241 | CONCERTA 27MG ER TAB (JAC) METHYLP (C) | STO | 2024-08-01 | 2024-12-31 | C | 30'S | 42 | 156.82 | 2024-08-01 | |||
| 41 | 17241 | CONCERTA 27MG ER TAB (JAC) METHYLPHENIDATE | STO | 2024-06-21 | 2024-07-31 | A | 30'S | 30 | 156.82 | 2024-06-18 | |||
| 41 | 17241 | CONCERTA 27MG ER TAB (JAC) METHYLPHENIDATE | STO | 2025-01-01 | 2025-01-31 | A | 30'S | 30 | 156.82 | 2024-12-31 | |||
| 41 | 2713N | CORTISOL 20MG TAB (ARP) PREDNISOLONE | AHI | 2024-04-01 | 2024-09-30 | A | 100'S | 90 | 8.21 | 2024-08-19 | |||
| 40 | 12011 | COSOPT 2%|0.5% EYE DR (MSD/STO) DORZOLA (C) | STO | 2022-04-01 | 2022-12-31 | C | 5ML | 24.76 | Delete from contract | 2022-12-31 | |||
| 42 | 0451BZ | COTRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETHO | AHI | 2026-04-01 | A | 10X10 | 56 | 7.12 | Price Change | 2025-10-31 | |||
| 40 | 7722BJ | CURAM 500MG | 125MG TAB (BCH/COL) AMOXICILLIN | CLAVULANIC ACID | COL | 2022-04-01 | 2024-03-31 | C | 80'S | 0 | 27.10 | Price Change | 2022-01-18 | ||
| 42 | 6132K | CYPROTERONE 100MG TAB (KWA) | STO | 2026-04-01 | A | 30'S | 90 | 43.55 | Add to Contract as Cat A | 2026-03-02 | |||