Contract Changes [25643 , 2024-04-01]

Contract Number	41
Brand Code	25643
Drug	GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD
LAgent Code	COL
Package Size	10'S
Formulary Category	A
Package Price	10.38
Protocol Monthly Max	10
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2024-12-03
Contract Changed
Change Date	2024-12-03