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 23871 - 23880 of 24215
| Identification Number | Trade Name | Benefit Category |
|---|---|---|
| 97799684 | INSET INFUSION SET 9MM CANNULA 110CM TUBING | This is not a Standard Benefit. Special Authorization is required. |
| 97799685 | INSET INFUSION SET 6MM CANNULA 110CM TUBING | This is not a Standard Benefit. Special Authorization is required. |
| 97799686 | INSET II 9MM CANNULA/23" TUBING INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 97799687 | INSET INFUSION SET 6MM CANNULA 60CM TUBING | This is not a Standard Benefit. Special Authorization is required. |
| 97799694 | SURE-T DISPOSABLE INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
| 97799704 | TRANSMITTER ADHESIVE PATCH 10/PACK | This is not a Standard Benefit. Special Authorization is required. |
| 97799708 | RESERVOIR 50X3ML SYR MMT-103A(10/PK) | This is not a Standard Benefit. Special Authorization is required. |
| 97799711 | SILHOUETTE 43IN. COMBO SET MMT-372 | This is not a Standard Benefit. Special Authorization is required. |
| 97799712 | SILHOUETTE 23IN. COMBO SET MMT-374 | This is not a Standard Benefit. Special Authorization is required. |
| 97799713 | PARADIGM SILHOUETTE 43" COMBO - INFUSION SET | This is not a Standard Benefit. Special Authorization is required. |
Displaying 23871 - 23880 of 24215