Important: The following data is for information purposes only. Please note that access to VAC drug benefits will vary depending upon an individual's eligibility and specific health needs. More Details
This information was posted August 29, 2012. Additions or revisions to the Formulary may have subsequently occurred.
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| Identification Number | Trade Name | Benefit Category |
|---|---|---|
| 28010060 | PUMP COMBO SET(INFUSION SET W/EXTRA CANNULA) | This is not a Standard Benefit. Special Authorization is required. |
| 28010080 | DIABETIC PUMP SUPPLIES MISCELLANEOUS | This is not a Standard Benefit. Special Authorization is required. |
| 44123001 | DEXTROSTIX BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123002 | ELITE BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123003 | ENCORE TEST STRIP | Standard Benefit for Eligible Clients |
| 44123004 | GLUCOFILM BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123005 | GLUCOSTIX BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123006 | ACCUTREND BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123007 | ACCU-CHEK EASY BG TEST STRIP | Standard Benefit for Eligible Clients |
| 44123008 | ADVANTAGE BG TEST STRIP | Standard Benefit for Eligible Clients |
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