Displaying 441 - 460 of 673
| 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 41 | 6211D | MIDAZOLAM 5MG/ML INJ (RTM) (B) | PHA | 2024-05-25 | 2026-03-31 | B | 10X3ML | 0 | 36.5 | 2024-04-01 | |||
| 40 | 6211D | MIDAZOLAM 5MG/ML INJ (RTM/PHA) | PHA | 2022-04-01 | 2024-03-31 | B | 10X3ML | 0 | $36.50 | PRICE CHANGE | 0000-00-00 | ||
| 40 | 3912F | MINOXIDIL 10MG TAB (KWA/ATB) | ATB | 2022-04-03 | 2024-03-31 | A | 10X10 | 120 | 93.13 | Price Change | 2022-06-14 | ||
| 40 | 3911C | MINOXIDIL 2.5MG TAB (KWA/ATB) | ATB | 2022-04-03 | 2024-03-31 | A | 10X10 | 120 | 56.79 | Price Change | 2022-06-14 | ||
| 41 | A041Q | MOFILET 500MG TAB (EMC) MYCOPHENOLATE | COL | 2024-04-01 | 2026-03-31 | BQ | 60'S | 180 | 61.98 | 2024-03-07 | |||
| 40 | 3653CK | MOMETASONE 50MCG NASAL SP (BCH/COL) | COL | 2022-04-01 | 2024-03-31 | A | 140 DOSES | 1 | 9.08 | Add to Contract as Cat A | 2021-07-29 | ||
| 40 | 1381C | MORPHINE 10MG/ML INJ (MTP/COL) | COL | 2022-07-15 | 2024-03-31 | B | 10X1ML | 0 | 12.64 | Price Change | 2022-07-14 | ||
| 40 | 1382G | MORPHINE 15MG/ML INJ (MTP/COL) | COL | 2022-07-15 | 2024-03-31 | B | 10X1ML | 0 | 13.84 | Price Change | 2022-07-14 | ||
| 40 | 13842 | MORPHINE 2MG/ML SOLN (MTP/COL) | COL | 2022-07-15 | 2024-03-31 | B | 500ML | 0 | 33.44 | Price Change | 2022-07-14 | ||
| 40 | 5281BB | MOXICIP 0.5% EYE DR (CIP/AHI) MOXIFLOXACIN | AHI | 2022-04-01 | 2022-09-30 | BQ | 5ML | 0 | 10.60 | 2022-03-29 | |||
| 40 | 3681V | NALOXONE 0.4MG/ML AMP (RTM/PHA) | PHA | 2023-03-20 | 2024-03-31 | 10'S | 57.86 | Price Change | 2023-02-14 | ||||
| 40 | 3681T | NALOXONE 0.4MG/ML INJ (MON/PHA) | PHA | 2023-03-20 | 2024-03-31 | BQ | 5X1ML | 13.54 | Delete from contract | 2023-02-14 | |||
| 40 | 3681G | NALOXONE 0.4MG/ML INJ (RTM/PHA) | PHA | 2022-04-01 | 2024-03-31 | BQ | 10X1ML | 49.25 | Add to Contract as Cat B | 2023-02-22 | |||
| 41 | 1421CM | NAPA 500MG TAB (BEX) PARACETAMOL | AHI | 2024-04-01 | 2026-03-31 | A | 510'S | 180 | 17.32 | 2023-10-27 | |||
| 40 | 35311 | NATELE CAP (BSP/AHI) MULTIVITAMINS + M (C) | AHI | 2022-10-01 | 2023-02-20 | C | 28'S | 14.9 | Price Change | 2023-02-02 | |||
| 40 | 35311 | NATELE CAP (BSP/AHI) MULTIVITAMINS PRE (C) | AHI | 2023-02-21 | 2024-03-31 | C | 28'S | 15.33 | Add to Contract as Cat C | 2023-02-21 | |||
| 40 | 35311 | NATELE CAP (BSP/AHI) MULTIVITAMINS PRENATAL | AHI | 2022-04-01 | 2022-09-30 | C | 28'S | 0 | 13.97 | 2022-03-29 | |||
| 41 | B4512 | NATRIXAM 10MG|1.5MG MR TAB (SER) A (C) | STO | 2024-06-01 | 2026-03-31 | C | 30'S | 30 | 7.39 | 2024-06-01 | |||
| 41 | B4512 | NATRIXAM 10MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE | STO | 2024-04-01 | 2024-05-31 | A | 30'S | 30 | 7.39 | 2024-04-30 | |||
| 41 | B4514 | NATRIXAM 10MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE | COL | 2024-04-01 | 2024-05-31 | A | 30'S | 30 | 7.39 | 2024-04-30 | |||