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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
41 B2244 LANTUS SOLOSTAR 100U/ML INJ (SFA) INSULIN GLARGINE INSULIN GLARGINE LANTUS SOLOSTAR 3ML VIAL A 27.18 27.1832 VIAL 2 VIAL SFA SANOFI AVENTIS COL COLLINS LTD B 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS 2024-04-01
42 B2244 LANTUS SOLOSTAR 100U/ML INJ (SFA) INSULIN GLARGINE INSULIN GLARGINE LANTUS SOLOSTAR 3ML VIAL A 27.18 27.18 VIAL 2 VIAL SFA SANOFI COL AVENTA BARBADOS B 682008 INSULINS 2026-04-01 SC 6 INSULINS
41 B2246 LANTUS 100U/ML INJ (SFA) INSULIN GLARGINE INSULIN GLARGINE LANTUS 10ML VIAL A 67.96 67.9581 VIAL 5 VIAL SFA SANOFI AVENTIS COL COLLINS LTD B 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS
42 B2246 LANTUS 100U/ML INJ (SFA) INSULIN GLARGINE INSULIN GLARGINE LANTUS 10ML VIAL A 67.96 67.96 VIAL 5 VIAL SFA SANOFI COL AVENTA BARBADOS B 682008 INSULINS 2026-04-01 SC 6 INSULINS
41 B2248 TOUJEO 300U/ML INJ (SFA) INSULIN GLARGINE (C) INSULIN GLARGINE TOUJEO 1.5ML VIAL C 68.09 68.094 VIAL 0 VIAL SFA SANOFI AVENTIS COL COLLINS LTD 682008 INSULINS 2024-04-01 2026-03-31 SC 0 INSULINS
42 B2248 TOUJEO 300U/ML INJ (SFA) INSULIN GLARGINE INSULIN GLARGINE TOUJEO 1.5ML VIAL C 68.09 68.09 VIAL 0 VIAL SFA SANOFI COL AVENTA BARBADOS 682008 INSULINS 2026-04-01 SC 0 INSULINS