Displaying 261 - 280 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 | 6132E | CYPROTERONE 100MG TAB (LDP/AHI) | AHI | 2022-04-01 | 2022-09-30 | A | 30'S | 90 | 44.85 | 2022-03-29 | |||
| 40 | 5231AD | DAKTARIN 2% CR (JAC/STO) MICONAZOLE | STO | 2022-04-01 | 2022-05-24 | C | 30G | 0 | 15.41 | Delete from contract | 2022-04-12 | ||
| 40 | 52352 | DAKTARIN 2% GEL (JAC/STO) MICONAZOLE | STO | 2022-04-01 | 2022-05-24 | BQ | 78G | 0 | 28.27 | Delete from contract | 2022-04-12 | ||
| 40 | A471S | DALTEPARIN 2500IU INJ (GLN/AHI) | AHI | 2022-04-01 | 2022-09-30 | B | 2500IU | 0 | 5.08 | 2022-03-29 | |||
| 40 | A472AD | DALTEPARIN 5000IU INJ (GLN/AHI) | AHI | 2022-04-01 | 2022-06-29 | B | 5000IU | 0 | 7.88 | 2022-03-29 | |||
| 40 | A472AD | DALTEPARIN 5000IU INJ (GLN/AHI) | AHI | 2022-06-30 | 2024-03-31 | B | 5000IU | 0 | 24.06 | Price Change | 2022-06-30 | ||
| 40 | 5921H | DANAZOL 200MG TAB (CIP/AHI) | AHI | 2022-04-01 | 2022-09-30 | C | 100'S | 0 | 645.85 | 2022-03-29 | |||
| 41 | B421H | DAPAGLIFLOZIN 5MG TAB (MCP) | AHI | 2024-04-01 | 2024-10-31 | A | 3X10 | 30 | 10.33 | 2024-09-19 | |||
| 41 | B421M | DAPAGLIFLOZIN 5MG TAB (MCP) | AHI | 2024-10-29 | 2026-03-31 | A | 100'S | 30 | 34.44 | 2024-09-20 | |||
| 41 | 0472J | DAPSONE 100MG TAB (GSK) | AHI | 2024-07-05 | 2026-03-31 | A | 1000'S | 90 | 141.35 | 2024-07-05 | |||
| 40 | 3962H | DEPAKENE 50MG/ML SYR (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 240ML | 28.49 | Delete from contract | 2023-03-02 | |||
| 40 | 3961AV | DEPAKOTE 250MG TAB (ABB) VALPROIC ACID | SBI | 0000-00-00 | 0000-00-00 | A | 30 | 90 | $21.42 | CHANGE OF DISTRIBUTOR | 0000-00-00 | ||
| 40 | 3961AP | DEPAKOTE 250MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 30'S | 21.42 | Delete from contract | 2023-03-07 | |||
| 40 | 3965C | DEPAKOTE 500MG TAB (ABB) SODIUM VALPROIC | SBI | 0000-00-00 | 0000-00-00 | A | 30 | 90 | $45.65 | CHANGE OF DISTRIBUTOR | 0000-00-00 | ||
| 40 | 39659 | DEPAKOTE 500MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 30'S | 45.67 | Delete from contract | 2023-03-02 | |||
| 40 | 3961AD | DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 100'S | 71.36 | Delete from contract | 2023-03-02 | |||
| 40 | 39654 | DEPAKOTE ER 500MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 100'S | 71.36 | Delete from contract | 2023-03-02 | |||
| 40 | A9632 | DERIVA 0.1% CR (GLP/ALI) ADAPALENE | ALI | 2022-04-01 | 2022-03-22 | C | 15G | 0 | 16.31 | Delete from contract | 2022-03-22 | ||
| 40 | A9635 | DERIVA 0.1% CR (GLP/ATB) ADAPALENE | ATB | 2022-04-01 | 2024-03-31 | C | 15G | 0 | 16.31 | Change Local Agent | 2022-03-22 | ||
| 42 | 4631AE | DESIRE GEL (HEA) GLYCERINE | STO | 2026-04-01 | B | 82G | 0 | 3.23 | Add to Contract as Cat B | 2026-02-27 | |||