Displaying 361 - 380 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 | 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 | |||
| 42 | A681JH | EFAVIRENZ|EMTRICITABINE||TENOFOVIR 600MG|200MG|300MG TAB (KW | STO | 2026-04-01 | BL | 60'S | 60 | 21.75 | Add to Contract | 2026-03-02 | |||
| 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 | ||
| 40 | A322KX | EFFEXOR XR 150MG CAP (PFI/STO) VENLAFAXINE | STO | 2022-07-12 | 2024-03-31 | C | 28'S | 0 | 135.59 | Package Size Change | 2022-07-12 | ||
| 40 | A322GB | EFFEXOR XR 75MG CAP (PFI/STO) VENLAFAXINE | STO | 2022-04-01 | 2022-08-23 | C | 14'S | 0 | 67.80 | Delete from contract | 2022-07-12 | ||
| 40 | A322KY | EFFEXOR XR 75MG CAP (PFI/STO) VENLAFAXINE | STO | 2022-07-12 | 2024-03-31 | C | 28'S | 0 | 135.59 | Package Size Change | 2022-07-12 | ||
| 42 | B1516 | ELIQUIS 2.5MG TAB (PFI) APIXABAN | STO | 2026-04-01 | B | 60'S | 60 | 175.33 | Change status from C to | 2026-03-05 | |||
| 42 | B1526 | ELIQUIS 5MG TAB (PFI) APIXABAN | STO | 2026-04-01 | B | 60'S | 60 | 175.33 | Change status from C to | 2026-03-05 | |||
| 41 | 3301BC | ELOCOM 0.1% CR (MSD) MOMETASONE | STO | 2024-04-01 | 2024-07-18 | A | 15G | 2 | 10.22 | 2024-06-06 | |||
| 41 | 3301BC | ELOCOM 0.1% CR (MSD) MOMETASONE (C) | STO | 2024-07-19 | 2026-03-31 | C | 15G | 2 | 10.22 | 2024-06-06 | |||
| 41 | 3302BC | ELOCON 0.1% OINT (MSD) MOMETASONE | STO | 2024-04-01 | 2024-07-18 | A | 15G | 2 | 12.04 | 2024-06-07 | |||
| 41 | 3302BC | ELOCON 0.1% OINT (MSD) MOMETASONE (C) | STO | 2024-07-19 | 2026-03-31 | C | 15G | 2 | 12.04 | 2024-06-07 | |||
| 40 | B041LQ | EMEP 40MG CAP (ARP/AHI) ESOMEPRAZOLE | AHI | 2022-04-01 | 2024-03-31 | C | 40'S | 0 | 16.36 | Add to Contract as Cat C | 2022-03-10 | ||
| 42 | A681JJ | EMTRICITABINE|TENOFOVIR 200MG|300MG TAB (KWA) | STO | 2026-04-01 | BL | 30'S | 60 | 18.40 | Add to Contract | 2026-03-02 | |||
| 42 | 5841JL | ENALAPRIL 10MG TAB (HEA) | AHI | 2026-04-01 | A | 10X10 | 90 | 5.16 | Price Change | 2025-10-31 | |||
| 42 | 5841JW | ENALAPRIL 10MG TAB (HEA) | CWS | 2026-04-01 | A | 10X10 | 90 | 5.16 | Add to Contract as Cat A | 2026-01-26 | |||