Contracted Products [DIANEAL (5B9896) 4.25% INJ (BAX/STO) DIALYSIS SOLN]

Contract Number	40
Brand Name	DIANEAL (5B9896) 4.25% INJ (BAX/STO) DIALYSIS SOLN
Package Size	6X2L
Formulary Category	B
Unit Price	18.49
Strength	4.25%
Max. Reimbursable / Month	0
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0