Contract Changes [6091G, 2022-07-12]

Contract Number	40
Brand Code	6091G
Drug	PENTOXIFYLLINE 400MG TAB (HEA/ATB)
LAgent Code	ATB
Package Size	10X10
Formulary Category	A
Package Price	21.18
Protocol Monthly Max	90
Drug Contract Start Date	2022-07-12
Drug Contract End Date	2024-03-31
Contract Changed	la
Change Date	2022-11-25