Displaying 61 - 80 of 674
| 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 | 13028 | ASPIRIN DISPERSIBLE 300MG TAB (ACD/AHI) | AHI | 2022-04-01 | 2024-03-31 | A | 32'S | 30 | 8.15 | Add to Contract as Cat A | 2022-03-11 | ||
| 40 | 1306AS | ASPIRIN E.C. 81MG TAB (REL/PHA) | PHA | 2022-04-01 | 2022-07-18 | A | 1000'S | 60 | 25.50 | Price Change | 2021-11-10 | ||
| 40 | 1306AS | ASPIRIN E.C. 81MG TAB (REL/PHA) | PHA | 2022-07-19 | 2024-03-31 | A | 1000'S | 60 | 20.97 | Price Change | 2022-07-18 | ||
| 41 | 1131DW | ATORSTAN 10MG TAB (REM) ATORVASTATI | SBI | 2024-04-01 | 2024-06-30 | A | 3x10 | 30 | 1.6 | 2024-03-25 | |||
| 41 | 1131DW | ATORSTAN 10MG TAB (REM) ATORVASTATI | SBI | 2024-08-07 | 2024-09-18 | A | 3x10 | 30 | 4.78 | 2024-08-07 | |||
| 41 | 1132ET | ATORSTAN 20MG TAB (REM) ATORVASTATI | SBI | 2024-04-01 | 2024-05-06 | A | 3x10 | 30 | 2.07 | 2024-03-25 | |||
| 41 | 1132ET | ATORSTAN 20MG TAB (REM) ATORVASTATI | SBI | 2024-08-07 | 2024-09-30 | A | 3x10 | 30 | 5.66 | 2024-08-07 | |||
| 41 | 1133DJ | ATORSTAN 40MG TAB (REM) ATORVASTATI | SBI | 2024-04-01 | 2024-06-30 | A | 3x10 | 60 | 3.02 | 2024-03-25 | |||
| 41 | 1133DJ | ATORSTAN 40MG TAB (REM) ATORVASTATI | SBI | 2024-08-07 | 2024-09-30 | A | 3x10 | 60 | 8.95 | 2024-08-07 | |||
| 41 | 1131FN | ATORVASTATIN 10MG TAB (TPP) | AHI | 2024-04-01 | 2026-03-31 | A | 10X10 | 30 | 3.86 | 2023-10-27 | |||
| 41 | 1132GS | ATORVASTATIN 20MG TAB (TPP) | AHI | 2024-04-01 | 2026-03-31 | A | 10X10 | 30 | 5.03 | 2023-10-27 | |||
| 40 | 1132GU | ATORVASTATIN 20MG TAB (UME/AHI) | AHI | 2022-04-01 | 2022-10-19 | A | 3X10 | 30 | 4.65 | Delete from contract | 2022-09-07 | ||
| 40 | 1132GU | ATORVASTATIN 20MG TAB (UME/AHI) | AHI | 2023-03-20 | 2024-03-31 | A | 3X10 | 30 | 1.74 | Add to Contract as Cat A | 2023-01-12 | ||
| 40 | 1133DC | ATORVASTATIN 40MG TAB (FSB/ATB) | ATB | 2022-04-01 | 2023-03-31 | A | 10X10 | 60 | 10.75 | 2022-03-30 | |||
| 40 | 07229 | AVEXA 30MG TAB (MBL/AHI) DEFLAZACORT | AHI | 2022-04-01 | 2024-03-31 | C | 1X10 | 0 | 29.00 | Add to Contract as Cat C | 2022-03-10 | ||
| 40 | 0131CW | AZITHROMYCIN 40MG/ML SUSP (KWA/ATB) | ATB | 2022-04-01 | 2022-09-30 | A | 15ML | 30 | 4.76 | 2022-03-30 | |||
| 40 | 4021C | AZITHROMYCIN 500MG INJ (DIL/AHI) | AHI | 2022-04-01 | 2022-09-30 | BQ | 10X500MG | 0 | 403.83 | 2022-03-29 | |||
| 40 | 0141GX | AZITHROMYCIN 500MG TAB (FSB/ATB) | ATB | 2022-04-01 | 2024-03-31 | A | 30'S | 7 | 13.65 | Add to Contract as Cat A | 2022-03-21 | ||
| 40 | 0141GZ | AZITHROMYCIN 500MG TAB (FSB/ATB) | ATB | 2022-04-19 | 2024-03-31 | A | 100'S | 7 | 43.68 | Add to Contract as Cat A | 2022-04-19 | ||
| 41 | 0141HN | AZITHROMYCIN 500MG TAB (MCP) | AHI | 2024-04-01 | 2024-05-15 | A | 30'S | 7 | 11.47 | 2024-04-03 | |||