Displaying 321 - 340 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 42 | 1605AA | DIAZEPAM 5MG/ML INJ (HEA) | CWS | 2026-04-01 | 2028-03-31 | B | 100X2ML | 0 | 102.21 | Add to Contract as Cat B | 2026-01-26 | ||
| 42 | 1605AB | DIAZEPAM 5MG/ML INJ (HEA) | STO | 2026-04-01 | B | 100X2ML | 0 | 102.21 | Add to Contract as Cat B | 2026-02-27 | |||
| 42 | 1605Z | DIAZEPAM 5MG/ML IV/IM INJ (HEA) | AHI | 2026-04-01 | B | 100X2ML | 60 | 102.21 | Price Change | 2025-10-31 | |||
| 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 | ||
| 42 | 4144EH | DICLOFENAC 100MG SR TAB (HEA) | STO | 2026-04-01 | A | 10X10 | 14 | 7.39 | Add to Contract as Cat A | 2026-02-27 | |||
| 42 | 4141TL | DICLOFENAC 50MG TAB (HEA) | STO | 2026-04-01 | A | 10X10 | 42 | 2.61 | Add to Contract as Cat A | 2026-02-27 | |||
| 42 | 4144EJ | DICLOFENAC 75MG SR TAB (HEA) | STO | 2026-04-01 | A | 10'S | 28 | 0.82 | Add to Contract as Cat A | 2026-02-27 | |||
| 42 | 6673BB | DICLOFENAC POTASSIUM 50MG TAB (FSB) | STO | 2026-04-01 | A | 10X10 | 15 | 2.75 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 6673AY | DICLOFENAC POTASSIUM 50MG TAB (HEA) | AHI | 2026-04-01 | C | 2X10 | 15 | 1.33 | Price Change | 2025-10-31 | |||
| 42 | 6673AZ | DICLOFENAC POTASSIUM 50MG TAB (HEA) | CWS | 2026-04-01 | C | 2X10 | 15 | 1.33 | Add to Contract as Cat C | 2026-01-26 | |||
| 42 | 6673BA | DICLOFENAC POTASSIUM 50MG TAB (HEA) © | STO | 2026-04-01 | C | 2X10 | 15 | 1.33 | Add to Contract as Cat C | 2026-02-27 | |||
| 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 | |||
| 42 | 4145AJ | DICLOFENAC SODIUM 0.1% EYE DR (FSB) | STO | 2026-04-01 | A | 5ML | 1 | 2.75 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 4144EB | DICLOFENAC SODIUM 100MG SR TAB (HEA) | AHI | 2026-04-01 | A | 10X10 | 14 | 7.39 | Price Change | 2025-10-31 | |||
| 42 | 4144EF | DICLOFENAC SODIUM 100MG SR TAB (HEA) | CWS | 2026-04-01 | A | 10X10 | 14 | 7.39 | Add to Contract as Cat A | 2026-01-26 | |||
| 42 | 4142CF | DICLOFENAC SODIUM 25MG/ML INJ (CHC) | STO | 2026-04-01 | B | 10X3ML | 0 | 0.84 | Add to Contract as Cat B | 2026-03-05 | |||
| 42 | 4141SU | DICLOFENAC SODIUM 50MG TAB (HEA) | AHI | 2026-04-01 | A | 10X10 | 42 | 2.61 | Price Change | 2025-10-31 | |||
| 42 | 4141TJ | DICLOFENAC SODIUM 50MG TAB (HEA) | CWS | 2026-04-01 | A | 10X10 | 42 | 2.61 | Add to Contract as Cat A | 2026-01-26 | |||