Contract Changes [3091J, 2026-04-01]

Contract Number	42
Brand Code	3091J
Drug	TETAGAM P 250IU/ML PREFIL SYRN (CSL) IMMUNOGLOBULIN HUMAN
LAgent Code	AHI
Package Size	4X1ML PFS
Formulary Category	B
Package Price	108.73
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