Contract Changes [375F1, 2026-04-01]

Contract Number	42
Brand Code	375F1
Drug	DIANEAL (5B9896) 4.25% SOLN (BAX) DIALYSIS SOLN
LAgent Code	STO
Package Size	6X2L
Formulary Category	BQ
Package Price	208.41
Protocol Monthly Max	0
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Contract Changed	Delete from contract
Change Date	2026-01-28