Displaying 301 - 320 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 | 3021X | LIDOCAINE 1% INJ (CIR/AHI) | AHI | 2022-04-01 | 2024-03-31 | B | 50ML VIAL | 0 | 4.70 | Add to Contract as Cat B | 2021-12-16 | ||
| 40 | 30247 | LIDOCAINE 2% GEL (CAD/PHA) | PHA | 2022-07-19 | 2024-03-31 | B | 30G | 0 | 3.18 | Price Change | 2022-07-18 | ||
| 40 | 5201FU | LIFESTYLE SKYN LRG (ANS/SBI) CONDOM | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 5.98 | Price Change | 2022-06-13 | ||
| 40 | 5201FW | LIFESTYLES SENSITIVE VARIETY (ANS/SBI) CON | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 5.77 | Price Change | 2022-06-13 | ||
| 40 | 5201Q | LIFESTYLES BARE RIDER (ANS/SBI) CONDOM | SBI | 2022-06-10 | 2024-03-31 | C | 3'S | 0 | 1.25 | Price Change | 2022-06-13 | ||
| 40 | 5201GA | LIFESTYLES KYNG GOLD (ANS/SBI) CONDOM | SBI | 2022-06-13 | 2024-03-31 | C | 3'S | 0 | 5.77 | Price Change | 2022-06-13 | ||
| 40 | 5201FT | LIFESTYLES SKYN ORIGINAL (ANS/SBI) CONDOM | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 5.98 | Price Change | 2022-06-13 | ||
| 40 | 5201FV | LIFESTYLES SKYN SELLECTION (ANS/SBI) CONDOM | SBI | 2022-04-01 | 2022-07-25 | C | 3'S | 0 | 4.24 | Delete from contract | 2022-06-13 | ||
| 40 | 5201N | LIFESTYLES STUDDED (ANS/SBI) CONDOM | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 6.16 | Price Change | 2022-06-13 | ||
| 40 | 5201GC | LIFESTYLES ULTRA RIBBED (ANS/SBI) CONDOM | SBI | 2022-06-13 | 2024-03-31 | C | 3'S | 0 | 2.10 | Price Change | 2022-06-13 | ||
| 40 | 5201FZ | LIFESTYLES ULTRA SENSITIVE (ANS/SBI) CONDOM | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 2.10 | Price Change | 2022-06-13 | ||
| 40 | 5201FS | LIFESTYLES ULTRA THIN (ANS/SBI) CONDOM | SBI | 2022-06-14 | 2024-03-31 | C | 3'S | 0 | 5.77 | Price Change | 2022-06-13 | ||
| 40 | 1131FW | LIPITAS 10MG TAB (INP/AHI) ATORVASTATIN | AHI | 2023-03-20 | 2024-03-31 | A | 30'S | 3.56 | Add to Contract as Cat A | 2023-01-04 | |||
| 40 | 1132HE | LIPITAS 20MG TAB (INP/AHI) ATORVASTATIN | AHI | 2023-03-20 | 2024-03-31 | A | 30'S | 30 | 4.32 | Add to Contract as Cat A | 2023-01-04 | ||
| 40 | 1133FV | LIPITAS 40MG TAB (INP/AHI) ATORVASTATIN | AHI | 2023-03-20 | 2024-03-31 | A | 30'S | 30 | 5.41 | Add to Contract as Cat A | 2023-01-04 | ||
| 40 | 5842GV | LISINOPRIL 20MG TAB (KWA/ATB) | ATB | 2022-04-01 | 2022-09-30 | A | 10X10 | 60 | 6.90 | 2022-03-30 | |||
| 40 | 5842HN | LISINOPRIL 20MG TAB (RYV/ATB) | ATB | 2022-04-01 | 2022-07-04 | A | 100'S | 60 | 7.04 | Delete from contract | 2022-05-23 | ||
| 40 | 5843DU | LISINOPRIL 5MG TAB (FSB/ATB) | ATB | 2022-04-01 | 2022-09-30 | A | 10X10 | 60 | 4.76 | 2022-03-30 | |||
| 40 | 0013PF | LORATADINE 1MG/ML SYRUP (HEA/ATB) | ATB | 2022-12-07 | 2024-03-31 | A | 100 ML | 3.13 | Change Local Agent | 2022-11-25 | |||
| 40 | 4622U | LORAZEPAM 2MG/ML INJ (FSB/ATB) | ATB | 2022-05-27 | 2024-03-31 | B | 1ML VIAL | 0 | 4.02 | Price Change | 2022-05-27 | ||