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.
Displaying 23091 - 23100 of 24215
| Identification Number | Trade Name | Benefit Category |
|---|---|---|
| 46340006 | ACM THINSET INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340007 | ANIMAS COMFORT INFUSION SET OR COMBO | This is not a Standard Benefit. Special Authorization is required. |
| 46340008 | ANIMAS CONTACT DETACH INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340009 | ANIMAS INSET II OR 30 INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340010 | DMSI ACCUCHEK RAPID D INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340011 | DMSI ACCUCHEK TENDER 1 OR 2 INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340012 | DMSI ACCUCHEK ULTRAFLEX 1 OR 2 INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340013 | MEDTRONIC PARADIGM POLYFIN QR INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340014 | MEDTRONIC PARADIGM QUICKSET INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340015 | MEDTRONIC PARADIGM SILHOUETTE INFUSION SET/COMBO | This is not a Standard Benefit. Special Authorization is required. |
Displaying 23091 - 23100 of 24215