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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 3701U SKY ERA GLUC (TTC/COL) DIAGNOSTIC BLOOD GLUC DIAGNOSTIC BLOOD GLUCOSE SKY ERA 50'S A 38.00 38.00 GLUCOSE STRI 1 PACK TTC TAIDOC TECHNOLOGY CORPORATION COL COLLINS LTD B 3626 DIABETES MELLITUS 2022-04-01 2024-03-31 6 DIAGNOSTIC AGENTS
41 3701U SKY ERA GLUC (TTC) DIAGNOSTIC BLOOD GLU DIAGNOSTIC BLOOD GLUCOSE SKY ERA 50'S A 38 38.0022 PACK 1 BOX TTC TAIDOC TECHNOLOGY CORPORATION COL COLLINS LTD B 3626 DIABETES MELLITUS 2024-04-01 2026-03-31 6 DIABETES MELLITUS
42 3701U SKY ERA GLUC (TTC) DIAGNOSTIC BLOOD GLU DIAGNOSTIC BLOOD GLUCOSE SKY ERA 50'S A 38.00 38.00 PACK 1 BOX TTC TAIDOC TECHNOLOGY CORPORATION COL AVENTA BARBADOS B 3626 DIABETES MELLITUS 2026-04-01 2028-03-31 6 DIABETES MELLITUS