Displaying 741 - 760 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 | 2962A | POSTINOR SD 1.5MG TAB (CHW/AHI) LEVONORGESTRE | AHI | 2022-04-01 | 2022-09-30 | C | 1'S | 0 | 12.23 | 2022-03-29 | |||
| 41 | 2012X | POTASSIUM CHLORIDE 2MEQ/ML INJ (FSB) (B) | ATB | 2024-04-01 | 2026-03-31 | B | 5X10ML | 0 | 5.71 | 2024-01-26 | |||
| 42 | 3262K | POVIDONE IODINE SCRUB (CHC) | STO | 2026-04-01 | B | 500ML | 0 | 250.77 | Add to Contract as Cat B | 2026-03-05 | |||
| 42 | 3261AB | POVIDONE IODINE 1% SOLN (FSB) | STO | 2026-04-01 | B | 1 LITRE | 500 | 17.37 | Add to Contract as Cat B | 2026-03-05 | |||
| 40 | 3261S | POVIDONE IODINE 1% SOLN (RIM/PHA) | PHA | 2023-03-20 | 2024-03-31 | B | 16OZ | 20.26 | Add to Contract as Cat B | 2023-02-20 | |||
| 41 | 3261U | POVIDONE IODINE 1% SOLN (RYV) (B) | ATB | 2024-04-01 | 2024-06-18 | B | 500ML | 500 | 13.51 | 2024-06-18 | |||
| 41 | 3261U | POVIDONE IODINE 1% SOLN (RYV) (B) | ATB | 2024-06-19 | 2026-03-31 | B | 500ML | 500 | 10.98 | 2024-06-19 | |||
| 40 | 3261U | POVIDONE IODINE 1% SOLN (RYV/ATB) | ATB | 2022-07-13 | 2024-03-31 | B | 500ML | 0 | 11.00 | Price Change | 2022-07-12 | ||
| 42 | B1521 | PRADAX 110MG TAB (BOE) DABIGATRAN | STO | 2026-04-01 | B | 3X10 | 60 | 96.64 | Change status from C to | 2026-01-28 | |||
| 42 | B1524 | PRADAX 110MG TAB (BOE) DABIGATRAN | STO | 2026-04-01 | B | 60'S | 60 | 193.27 | Change status from C to | 2026-01-28 | |||
| 42 | B1531 | PRADAX 150MG TAB (BOE) DABIGATRAN | STO | 2026-04-01 | B | 60'S | 60 | 193.27 | Change status from C to | 2026-02-05 | |||
| 42 | B1511 | PRADAX 75MG TAB (BOE) DABIGATRAN | STO | 2026-04-01 | B | 3X10 | 60 | 96.64 | Change status from C to | 2026-02-05 | |||
| 41 | 2713R | PREDNISOLONE 20MG TAB (ARP) | AHI | 2024-10-01 | 2026-03-31 | A | 50'S | 90 | 4.1 | 2024-08-20 | |||
| 40 | 2713E | PREDNISOLONE 20MG TAB (MBL/AHI) | AHI | 2023-03-20 | 2024-03-31 | A | 100'S | 90 | 17.29 | Add to Contract as Cat A | 2023-01-20 | ||
| 40 | A0825 | PREVNAR 13 16MCG INJ (PFI/STO) PNEUMOCOCCAL | STO | 2022-06-22 | 2024-03-31 | B | 1 DOSE | 0 | 223.12 | Price Change | 2022-06-22 | ||
| 40 | 7621BF | PRIMAFEN 30MCG|150MCG TAB (ABB/PHA) ETHINYLESTRADIOL|LEVONORGESTRE (C) | PHA | 2022-04-01 | 2023-03-31 | C | 21'S | 4.57 | Delete from contract | 2023-03-02 | |||
| 42 | 3082D | PRIVIGEN 10% INJ (CSL) HUMAN IMMUNOGLOBULIN | AHI | 2026-04-01 | BQ | 100ML | 0 | 1,603.81 | Add to Contract | 2025-11-10 | |||
| 40 | 30828 | PRIVIGEN 10% INJ (CSL/AHI) IMMUNOGLOBULIN | AHI | 2022-04-01 | 2022-05-10 | BQ | 100ML | 0 | 1,413.53 | 2022-03-29 | |||
| 40 | 59314 | PROCORALAN 5MG TAB (SER/COL) IVABRADINE | COL | 2022-04-13 | 2024-03-31 | C | 28'S | 0 | 60.87 | Add to Contract as Cat C | 2022-04-13 | ||
| 40 | 59311 | PROCORALAN 5MG TAB (SER/STO) IVABRADINE | STO | 2022-04-06 | 2024-03-31 | C | 28'S | 0 | 60.87 | Package Size Change | 2022-04-06 | ||