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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
40 3701BE SELECT FLEX PLUS GLUC (JOH/AAL) DIAGNOSTIC B DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 39.42 39.42 GLUCOSE STRI 1 PACK JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2022-04-01 2024-03-31 6 DIAGNOSTIC AGENTS
41 3701BE SELECT FLEX PLUS GLUC (JOH) DIAGNO DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 39.23 39.2254 PACK 1 BOX JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2024-04-01 2026-03-31 6 DIABETES MELLITUS
42 3701BE SELECT FLEX PLUS GLUC (JOH) DIAGNO DIAGNOSTIC BLOOD GLUCOSE SELECT FLEX PLUS 50'S A 40.39 40.39 PACK 1 BOX JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2026-04-01 2028-03-31 6 DIABETES MELLITUS
40 3701V LIFESCAN ONE TOUCH ULTRA GLUC (JOH/AAL) DIAG DIAGNOSTIC BLOOD GLUCOSE LIFESCAN ONE TOUCH ULTRA 50'S A 39.42 39.42 GLUCOSE STRI 1 PACK JOH JOHNSON & JOHNSON (T'DAD) LTD. AAL A. A. LAQUIS LTD B 3626 DIABETES MELLITUS 2022-04-01 2024-03-31 6 DIAGNOSTIC AGENTS