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 23101 - 23110 of 24215
| Identification Number | Trade Name | Benefit Category |
|---|---|---|
| 46340016 | MEDTRONIC PARADIGM SOFSET QR INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340017 | MEDTRONIC PARADIGM SURE-T INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340018 | MEDTRONIC MINIMED POLYFIN OR QR INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340019 | MEDTRONIC MINIMED QUICKSET INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340020 | MEDTRONIC MINIMED SILHOUETTE INFUSION SET OR COMBO | This is not a Standard Benefit. Special Authorization is required. |
| 46340021 | MEDTRONIC MINIMED SOFSET OR SOFSET QR INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340022 | MEDTRONIC SILHOUETTE CANNULA ONLY | This is not a Standard Benefit. Special Authorization is required. |
| 46340023 | ACM NERIA DETACH INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 46340025 | OMNIPOD (INFUSION/RESERVOIR) | This is not a Standard Benefit. Special Authorization is required. |
| 46340028 | OMNIPOD INSULIN DELIVERY POD | This is not a Standard Benefit. Special Authorization is required. |
Displaying 23101 - 23110 of 24215