Displaying 441 - 460 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 | 2594EJ | FOMODIN 40MG TAB (ANC) FAMOTIDINE | SBI | 2026-04-01 | A | 10X10 | 30 | 4.89 | Add to Contract as Cat A | 2026-02-11 | |||
| 40 | 5511AV | FORSURE INSULIN SYRINGES 31GX1\2" (CSC/PHA) | PHA | 2022-04-01 | 2022-07-27 | A | 100X1ML | 10 | 21.50 | Delete from contract | 2022-06-15 | ||
| 41 | B4217 | FORXIGA 10MG TAB (AZN) DAPAGLIFLOZI | COL | 2024-04-01 | 2024-06-30 | A | 30'S | 30 | 61.6 | 2024-03-13 | |||
| 41 | B4217 | FORXIGA 10MG TAB (AZN) DAPAGLIFLOZI | COL | 2024-08-16 | 2026-03-31 | B | 30'S | 30 | 61.6 | 2024-08-16 | |||
| 41 | B4218 | FORXIGA 5MG TAB (AZN) DAPAGLIFLOZIN | COL | 2024-04-01 | 2024-04-24 | A | 30'S | 30 | 61.6 | 2024-03-13 | |||
| 41 | B4218 | FORXIGA 5MG TAB (AZN) DAPAGLIFLOZIN | COL | 2024-08-16 | 2026-03-31 | B | 30'S | 30 | 61.6 | 2024-08-16 | |||
| 42 | 37019 | FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC | PHA | 2026-04-01 | A | 50'S | 1 | 42.13 | Price Change | 2025-10-08 | |||
| 41 | 3701AZ | FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC | SBI | 2024-04-01 | 2026-03-31 | A | 50'S | 1 | 42.13 | 2024-01-02 | |||
| 40 | 37019 | FREESTYLE OPTIUM GLUC (ABD/PHA) DIAGNOSTIC B | PHA | 2023-02-20 | 2024-03-31 | A | 50'S | 40.01 | Price Change | 2023-01-09 | |||
| 41 | 5231FJ | FUNGI-EZE 1% CR (INF) TERBINAFINE | RXP | 2024-04-24 | 2026-03-31 | A | 30G TUBE | 2 | 3.94 | 2024-04-24 | |||
| 42 | 4252AD | FUSIDIC ACID 2% CR (CHC) | STO | 2026-04-01 | A | 15G | 2 | 3.34 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 4252AE | FUSIDIC ACID 2% CR (FSB) | STO | 2026-04-01 | A | 15G | 2 | 2.20 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 4253BE | FUSIDIC ACID 2% OINT (CHC) | STO | 2026-04-01 | A | 15G | 2 | 4.70 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 4253BF | FUSIDIC ACID 2% OINT (FSB) | STO | 2026-04-01 | A | 15G | 2 | 2.75 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 0314B | FUSIDIC ACID DRESSING 1% DRESSING (LDP) | AHI | 2026-04-01 | A | 10'S | 10 | 18.97 | Add to Contract as Cat A | 2026-03-18 | |||
| 42 | 4252AC | FUSIJOHN 2% CR (JLP) FUSIDIC ACID | AHI | 2026-04-24 | A | 10G | 2 | 4.08 | Package Size Change | 2026-04-24 | |||
| 40 | A231BE | GABAPENTIN 300MG CAP (AUR/AHI) | AHI | 2022-04-01 | 2024-03-31 | A | 100'S | 180 | 11.69 | Price Change | 2022-04-01 | ||
| 42 | A231AE | GABAPENTIN 300MG CAP (FSB) | STO | 2026-04-01 | A | 100'S | 180 | 7.04 | Add to Contract as Cat A | 2026-03-05 | |||
| 40 | 0321AB | GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) | PHA | 2022-06-01 | 2024-03-31 | B | 10X2ML | 0 | 19.27 | Price Change | 2022-05-31 | ||
| 40 | 0321AX | GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI | ATB | 2022-07-12 | 2024-03-31 | B | 10X2ML | 0 | 6.74 | Price Change | 2022-07-11 | ||