Displaying 141 - 160 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 | 5921H | DANAZOL 200MG TAB (CIP/AHI) | AHI | 2022-04-01 | 2022-09-30 | C | 100'S | 0 | 645.85 | 2022-03-29 | |||
| 40 | 3962H | DEPAKENE 50MG/ML SYR (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 240ML | 28.49 | Delete from contract | 2023-03-02 | |||
| 40 | 3961AP | DEPAKOTE 250MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 30'S | 21.42 | Delete from contract | 2023-03-07 | |||
| 40 | 39659 | DEPAKOTE 500MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 30'S | 45.67 | Delete from contract | 2023-03-02 | |||
| 40 | 3961AD | DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 100'S | 71.36 | Delete from contract | 2023-03-02 | |||
| 40 | 39654 | DEPAKOTE ER 500MG TAB (ABB/PHA) VALPROIC ACID | PHA | 2022-04-01 | 2023-03-31 | A | 100'S | 71.36 | Delete from contract | 2023-03-02 | |||
| 40 | A9632 | DERIVA 0.1% CR (GLP/ALI) ADAPALENE | ALI | 2022-04-01 | 2022-03-22 | C | 15G | 0 | 16.31 | Delete from contract | 2022-03-22 | ||
| 40 | A9635 | DERIVA 0.1% CR (GLP/ATB) ADAPALENE | ATB | 2022-04-01 | 2024-03-31 | C | 15G | 0 | 16.31 | Change Local Agent | 2022-03-22 | ||
| 40 | 4631N | DESIRE JELLY (HEA/ATB) LUBRICATING JELLY(B) | ATB | 2022-12-07 | 2024-03-31 | B | 82G | 3.26 | Change Local Agent | 2022-11-25 | |||
| 40 | 20553 | DEXTROSE 10% (CSC/PHA) | PHA | 2022-04-01 | 2022-06-15 | B | 250ML | 0 | 2.65 | Price Change | 2021-11-10 | ||
| 40 | 20553 | DEXTROSE 10% (CSC/PHA) | PHA | 2022-06-16 | 2024-03-31 | B | 250ML | 0 | 3.02 | Price Change | 2022-06-15 | ||
| 40 | 20578 | DEXTROSE 10% (CSC/PHA) PLASTIC BAG | PHA | 2022-04-01 | 2022-06-15 | B | 1 LITRE | 0 | 4.50 | Price Change | 2021-11-10 | ||
| 40 | 20578 | DEXTROSE 10% (CSC/PHA) PLASTIC BAG | PHA | 2022-04-16 | 2024-03-31 | B | 1 LITRE | 0 | 5.01 | Price Change | 2022-06-15 | ||
| 40 | 2053A | DEXTROSE 5% (CSC/PHA) | PHA | 2022-04-01 | 2022-06-15 | B | 500ML | 0 | 2.50 | Price Change | 2021-11-10 | ||
| 40 | 2053A | DEXTROSE 5% (CSC/PHA) | PHA | 2022-06-16 | 2024-03-31 | B | 500ML | 0 | 2.80 | Price Change | 2022-06-15 | ||
| 40 | 2054C | DEXTROSE 5% (CSC/PHA) | PHA | 2022-04-01 | 2022-06-15 | B | 1 LITRE | 0 | 3.95 | Price Change | 2021-11-10 | ||
| 40 | 2054C | DEXTROSE 5% (CSC/PHA) | PHA | 2022-06-16 | 2022-07-18 | B | 1 LITRE | 0 | 4.20 | Price Change | 2022-06-15 | ||
| 40 | 2054C | DEXTROSE 5% (CSC/PHA) | PHA | 2022-07-19 | 2024-03-31 | B | 1 LITRE | 0 | 3.98 | Price Change | 2022-07-18 | ||
| 40 | 20523 | DEXTROSE 5% INJ (CSC/PHA) | PHA | 2022-04-01 | 2022-06-15 | B | 250ML | 0 | 2.65 | Price Change | 2021-11-10 | ||
| 40 | 20523 | DEXTROSE 5% INJ (CSC/PHA) | PHA | 2022-06-16 | 2024-03-31 | B | 250ML | 0 | 3.02 | Price Change | 2022-06-15 | ||