Contract Changes [51316, 2022-04-01]

Contract Number	40
Brand Code	51316
Drug	XALACOM 0.005% /0.5% EYE DR (PFI/SBI) LATANOP
LAgent Code	SBI
Package Size	2.5ML
Formulary Category	C
Package Price	37.90
Protocol Monthly Max	0
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Contract Changed	Price Change
Change Date	2022-05-05