Contract Changes [0472J, 2024-07-05]

Contract Changes [0472J, 2024-07-05]

Contract Number	41
Brand Code	0472J
Drug	DAPSONE 100MG TAB (GSK)
LAgent Code	AHI
Package Size	1000'S
Formulary Category	A
Package Price	141.35
Protocol Monthly Max	90
Drug Contract Start Date	2024-07-05
Drug Contract End Date	2026-03-31
Contract Changed
Change Date	2024-07-05