Displaying 721 - 740 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 | 1453H | PETHIDINE 50MG/ML INJ (MTP/COL) | COL | 2022-07-15 | 2024-03-31 | BQ | 10X2ML | 0 | 15.34 | Price Change | 2022-07-14 | ||
| 40 | 23539 | PHENYLEPHRINE 10MG/ML INJ (SLS/AHI) | AHI | 2022-04-01 | 2022-09-30 | B | 1ML AMP | 0 | 22.07 | 2022-03-29 | |||
| 42 | 1512AP | PHENYTOIN 100MG CHEW TAB (KWA) | STO | 2026-04-01 | A | 100'S | 180 | 17.83 | Add to Contract as Cat A | 2026-03-02 | |||
| 42 | 1514Y | PHENYTOIN 50MG/ML INJ (FSB) | STO | 2026-04-01 | B | 5X5ML | 2 | 8.37 | Add to Contract as Cat B | 2026-03-05 | |||
| 40 | 1514M | PHENYTOIN 50MG/ML INJ (MON/PHA) | PHA | 2022-07-19 | 2024-03-31 | B | 5X5ML | 0 | 9.62 | Price Change | 2022-07-18 | ||
| 40 | 3523F | PHYTOMENADIONE 10MG/ML IV/IM INJ (RTM/PHA) | PHA | 2022-07-19 | 2024-03-31 | B | 10X1ML | 0 | 15.40 | Price Change | 2022-07-18 | ||
| 42 | 3522M | PHYTOMENADIONE 1MG IM INJ (SLS) | AHI | 2026-04-02 | B | 25X0.5ML | 2 | 214.75 | Add to Contract as Cat B | 2026-04-02 | |||
| 40 | 2331J | PILOCARPINE 2% EYE DR (MTP/COL) | COL | 2022-04-01 | 2024-03-31 | A | 10ML | 1 | 15.25 | Price Change | 2022-03-18 | ||
| 41 | 2332H | PILOCARPINE 4% EYE DR (MTP) (C) | COL | 2024-04-11 | 2026-03-31 | C | 10ML | 1 | 21.56 | 2024-04-10 | |||
| 40 | 2332H | PILOCARPINE 4% EYE DR (MTP/COL) | COL | 2022-04-01 | 2024-03-31 | C | 10ML | 0 | 16.74 | Price Change | 2022-03-18 | ||
| 40 | A7017 | PILOCARPINE | TIMOLOL 2% | 0.5% EYE DR (FSB/ATB) | ATB | 2022-04-01 | 2024-03-31 | A | 5ML | 1 | 5.76 | Price Change | 2021-12-08 | ||
| 40 | A7026 | PILOCARPINE | TIMOLOL 4% | 0.5% EYE DR (FSB/ATB) | ATB | 2022-04-01 | 2024-03-31 | A | 5ML | 1 | 7.04 | Price Change | 2021-12-08 | ||
| 42 | A7019 | PILOCARPINE|TIMOLOL 2%|0.5% EYE DR (CHC) | STO | 2026-04-01 | A | 5ML | 1 | 19.52 | Add to Contract as Cat A | 2026-03-05 | |||
| 40 | 7726BS | PIPERACILLIN | TAZOBACTAM 4G | 0.5G INJ (UME/AHI) | AHI | 2022-04-01 | 2022-09-30 | BQ | 4.5G VIAL | 0 | 4.46 | 2022-03-29 | |||
| 42 | 3921ER | PLASEP 75MG TAB (MSN) CLOPIDOGREL | STO | 2026-04-01 | A | 3X10 | 30 | 2.47 | Add to Contract as Cat A | 2026-03-23 | |||
| 40 | 3921CK | PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL | ATB | 2022-09-06 | 2024-03-31 | A | 3X10 | 30 | 2.16 | Price Change | 2022-07-26 | ||
| 40 | A0811 | PNEUMOVAX 23 INJ (MSD/STO) PNEUMOCOCCAL | STO | 2022-07-26 | 2024-03-31 | C | 0.5ML VIAL | 0 | 23.98 | Package Size Change | 2022-07-26 | ||
| 40 | 4073X | POENTIMOL 0.5% EYE DR (LPO/COL) TIMOLOL | COL | 2022-04-01 | 2024-03-31 | C | 5ML | 0 | 5.44 | Add to Contract as Cat C | 2022-04-01 | ||
| 42 | 4701BS | POLYETHYLENE GLYCOL|PROPYLENE GLYCOL 0.4%|0.3% EYE DR (CHC) | STO | 2026-04-01 | A | 15ML | 1 | 1.25 | Add to Contract as Cat A | 2026-03-05 | |||
| 40 | 2962R | POST DAY 1.5MG TAB (ABB/PHA) LEVONORGESTREL (C) | PHA | 2022-04-01 | 2023-04-13 | C | 1'S | 9.89 | Delete from contract | 2023-03-02 | |||