Displaying 1 - 20 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 41 | 2841GM | METFOR-EZE 500MG ER TAB (INF) METFORMIN XR | RXP | 2024-04-24 | 2026-03-31 | A | 100'S | 120 | 7.48 | 2024-04-24 | |||
| 40 | 41519 | AAP-BROMOCRIPTINE 2.5MG TAB (APO/COL) | COL | 2022-04-01 | 2024-03-31 | C | 100'S | 0 | 44.28 | Name Change | 2022-04-04 | ||
| 40 | 60914 | AAP-PENTOXIFYLLINE SR 400MG TAB (APO/COL) | COL | 2022-04-01 | 2024-03-31 | C | 100'S | 0 | 23.65 | Name Change | 2022-04-04 | ||
| 40 | 17026 | AAP-TRIFLUOPERAZINE 5MG TAB (APO/COL) | COL | 2022-04-01 | 2024-03-31 | A | 100'S | 180 | 6.25 | NAME CHANGED TO AAP | 2022-12-31 | ||
| 40 | 17026 | AAP-TRIFLUOPERAZINE 5MG TAB (APO/COL) | COL | 2022-04-01 | 2024-03-31 | A | 100'S | 6.25 | Name Change | 2023-02-01 | |||
| 42 | 2281AU | ACETAZOLAMIDE 250MG TAB (FSB) | STO | 2026-04-01 | A | 1000'S | 120 | 55.54 | Add to Contract as Cat A | 2026-03-05 | |||
| 40 | 22819 | ACETAZOLAMIDE 250MG TAB (KWA/ATB) | ATB | 2022-04-01 | 2024-03-31 | A | 10X10 | 120 | 80.79 | 2022-03-30 | |||
| 40 | 22826 | ACETAZOLAMIDE 500MG INJ (XGE/AHI) | AHI | 2022-04-01 | 2022-09-30 | BQ | 1DOSE SYRN | 0 | 165.44 | 2022-03-29 | |||
| 41 | 79714 | ACT-HIB 24MCG|10MCG INJ (AVP) DIPHTHERIA TOXOID|HAEMOPHILUS (B) | COL | 2024-04-01 | 2024-10-21 | B | 1 DS VIAL | 0 | 19.57 | 2024-09-09 | |||
| 42 | 0521A | ACTINOMYCIN D 500MCG INJ (KWA) DACTINOMYCIN | STO | 2026-04-01 | BQ | 500MCG VIA | 0 | 16.72 | Add to Contract | 2026-03-02 | |||
| 40 | 7722CM | ACUCLAV 500MG/125MG TAB (MCP/AHI) | AHI | 2023-06-06 | 2024-03-31 | B | 20's | 21 | $3.54 | B | 2023-06-09 | ||
| 42 | 5696AA | ACYCLOVIR 400MG DISP TAB (HEA) | STO | 2026-04-01 | A | 1X10 | 50 | 3.91 | Add to Contract as Cat A | 2026-02-27 | |||
| 42 | 5696AH | ACYCLOVIR 400MG DISP TAB (HEA) | CWS | 2026-04-01 | A | 1X10 | 50 | 3.91 | Add to Contract as Cat A | 2026-01-26 | |||
| 42 | 5696W | ACYCLOVIR 400MG DISP TAB (HEA) | AHI | 2026-04-01 | A | 1X10 | 50 | 3.91 | Price Change | 2025-10-31 | |||
| 42 | 5694AJ | ACYCLOVIR 5% CR (FSB) | STO | 2026-04-01 | A | 5G | 2 | 1.09 | Add to Contract as Cat A | 2026-03-05 | |||
| 42 | 5694AH | ACYCLOVIR 5% CR (HEA) | CWS | 2026-04-01 | A | 5G TUBE | 2 | 1.41 | Add to Contract as Cat A | 2026-01-26 | |||
| 42 | 5694AK | ACYCLOVIR 5% CR (HEA) | STO | 2026-04-01 | A | 5G | 2 | 1.41 | Add to Contract as Cat A | 2026-02-27 | |||
| 40 | 5694Z | ACYCLOVIR 5% CR (HEA/ATB) | ATB | 2022-07-12 | 2024-03-31 | A | 5G | 2 | 2.58 | la | 2022-11-25 | ||
| 40 | 5691M | ACYCLOVIR 50MG/ML INJ (CHC/ATB) | ATB | 2022-04-01 | 2024-03-31 | BQ | 10ML | 0 | 9.05 | Price Change | 2021-12-03 | ||
| 42 | 5691T | ACYCLOVIR 50MG/ML INJ (FSB) | STO | 2026-04-01 | BQ | 10ML | 15 | 2.36 | Add to Contract | 2026-03-05 | |||