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 23751 - 23760 of 24215
| Identification Number | Trade Name | Benefit Category |
|---|---|---|
| 95097108 | SENSURA MIO CLICK 2 PC POUCH | Standard Benefit for Eligible Clients |
| 95699997 | ORTHOVISC | Standard Benefit for Eligible Clients |
| 96599943 | NEOVISC ONE 60MG/4ML | Standard Benefit for Eligible Clients |
| 96599992 | SYNVISC ONE GF20 6ML INJECTION | Standard Benefit for Eligible Clients |
| 96599996 | EUFLEXXA 1% | Standard Benefit for Eligible Clients |
| 96599997 | ORTHOVISC | Standard Benefit for Eligible Clients |
| 96899968 | AEROCHAMBER PLUS FLOW-VU WITH MOUTHPIECE | Standard Benefit for Eligible Clients |
| 97799076 | OMNIPOD DASH SYSTEM POD | This is not a Standard Benefit. Special Authorization is required. |
| 97799077 | OMNIPOD DASH PERSONAL DIABETES MANAGER | This is not a Standard Benefit. Special Authorization is required. |
| 97799079 | OMNIPOD DASH PDM KIT | This is not a Standard Benefit. Special Authorization is required. |
Displaying 23751 - 23760 of 24215