Contract Changes [3061E, 2026-04-01]

Contract Number	42
Brand Code	3061E
Drug	RHOPHYLAC 150MCG/ML PREFIL SYRN (CSL) IMMUNOGLOBULIN ANTI-D
LAgent Code	AHI
Package Size	1X2ML PFS
Formulary Category	BQ
Package Price	122.32
Protocol Monthly Max	0
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Contract Changed	Add to Contract
Change Date	2025-11-10