Displaying 481 - 486 of 486
| 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 | 23717 | XYLOMETAZOLINE 0.1% NASAL DR (CIR/AHI) | AHI | 2022-04-01 | 2022-09-30 | A | 10ML | 1 | 2.66 | 2022-03-29 | |||
| 40 | 4463F | YASNAL Q 5MG TAB (KRK/AHI) DONEPEZIL | AHI | 2022-06-17 | 2022-09-30 | A | 28'S | 30 | 30.09 | 2022-06-17 | |||
| 40 | 4464E | YASNAL Q DISP 10MG TAB (KRK/AHI) DONEPEZIL | AHI | 2022-06-17 | 2022-09-30 | A | 28'S | 30 | 47.57 | 2022-06-17 | |||
| 40 | 0112CH | ZINNAT 50MG/ML SUSP (GSK/COL) CEFUROXIME | COL | 2022-04-01 | 2024-03-31 | C | 70ML | 0 | 25.66 | Package Size Change | 2022-03-21 | ||
| 40 | 51554 | ZIPRASIDONE 20MG INJ (DRL/AHI) | AHI | 2022-04-01 | 2024-03-31 | BP | 10X1ML | 0 | 1,259.32 | Package Size Change | 2021-12-16 | ||
| 40 | 4101A | ZOLENDRONIC ACID 4MG INJ (SLS/AHI) | AHI | 2022-04-01 | 2022-09-30 | BQ | 4MG VIAL | 0 | 38.95 | 2022-03-29 | |||