Medical Supplies
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| Generic Name | Brand Name | Form | PDL Status |
Current Drug Use Criteria | Carveout ‐ Bill FFS |
New Drug Evaluation & Updates |
|---|---|---|---|---|---|---|
| blade lancet, safety | ASSURE HAEMOLANCE PLUS | EACH | Y | N | ||
| blade lancet, safety | MEDLANCE PLUS SPECIAL BLADE | EACH | Y | N | ||
| blood glucose cntl high,normal | 2TEK | EACH | Y | N | ||
| blood glucose cntl high,normal | AGAMATRIX CONTROL | EACH | Y | N | ||
| blood glucose cntl high,normal | ASSURE PRISM | EACH | Y | N | ||
| blood glucose cntl high,normal | CARESENS | EACH | Y | N | ||
| blood glucose cntl high,normal | CARETOUCH CONTROL SOLUTION | EACH | Y | N | ||
| blood glucose cntl high,normal | ACCU-CHEK COMPACT BLUE CONTROL | EACH | Y | N | ||
| blood glucose control high,low | EVENCARE G2 | EACH | Y | N | ||
| blood glucose control high,low | ULTRATRAK ULTIMATE | EACH | Y | N | ||
| blood glucose control high,low | TELCARE CONTROL SOLUTION | EACH | Y | N | ||
| blood glucose control high,low | MICRODOT | EACH | Y | N | ||
| blood glucose control high,low | HARMONY CONTROL SOLUTION | EACH | Y | N | ||
| blood glucose control high,low | EVENCARE PROVIEW CONTROL SOLN | EACH | Y | N | ||
| blood glucose control high,low | EVENCARE G3 | EACH | Y | N | ||
| blood glucose control high,low | ACCU-CHEK GUIDE CONTROL SOLN | EACH | Y | N | ||
| blood glucose control high,low | ASSURE PRO | EACH | Y | N | ||
| blood glucose control high,low | EASY TOUCH CONTROL SOLUTION | EACH | Y | N | ||
| blood glucose ctl high,nml,low | ON CALL EXPRESS CONTROL SOLN | EACH | Y | N | ||
| blood glucose ctl high,nml,low | GLUCOSE CONTROL SOLUTION | EACH | Y | N | ||
| blood-gluc.meter, wrist bp mon | ADVOCATE REDI-CODE DUO | EACH | Y | N | ||
| blood-gluc.meter, wrist bp mon | ADVOCATE DUO | EACH | Y | N | ||
| blood-gluc.meter, wrist bp mon | 2TEK | KIT | Y | N | ||
| blood-glucose calib. control | ACCU-CHEK | COMBO. PKG | Y | N | ||
| blood-glucose calib. control | PRECISION GLUCOSE CONTROL | COMBO. PKG | Y | N | ||
| blood-glucose calib. control | MEDISENSE CONTROL | COMBO. PKG | Y | N | ||
| blood-glucose calib. control | AT LAST | SOLUTION | Y | N | ||
| blood-glucose calib. control | GLUCOMETER DEX | SOLUTION | Y | N | ||
| blood-glucose control, high | UNISTRIP | EACH | Y | N | ||
| blood-glucose control, high | TRUECONTROL | EACH | Y | N | ||
| blood-glucose control, high | ELEMENT COMPACT CONTROL SOLN | EACH | Y | N | ||
| blood-glucose control, high | EMBRACE | EACH | Y | N | ||
| blood-glucose control, high | EMBRACE WAVE CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, high | FORACARE GDH | EACH | Y | N | ||
| blood-glucose control, high | GLUCOCOM CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, high | ONETOUCH VERIO HIGH CNTRL SOLN | EACH | Y | N | ||
| blood-glucose control, high | RIGHTEST CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, high | EZ SMART | EACH | Y | N | ||
| blood-glucose control, high | ADVOCATE REDI-CODE+ CTRL SOLN | EACH | Y | N | ||
| blood-glucose control, high | EASY TRAK | EACH | Y | N | ||
| blood-glucose control, high | EASY TALK PLUS II | EACH | Y | N | ||
| blood-glucose control, high | COOL CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, high | EASY PLUS II | EACH | Y | N | ||
| blood-glucose control, low | FORACARE GDH | EACH | Y | N | ||
| blood-glucose control, low | ELEMENT CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, low | EMBRACE GLUCOSE CONTROL SOLN | EACH | Y | N | ||
| blood-glucose control, low | EASY TRAK | EACH | Y | N | ||
| blood-glucose control, low | EASY TALK PLUS II | EACH | Y | N | ||
| blood-glucose control, low | INFINITY CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, low | PRODIGY CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, low | TD GOLD LEVEL 1 CONTROL SOL | EACH | Y | N | ||
| blood-glucose control, low | CONTOUR NEXT CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, low | ADVOCATE REDI-CODE+ CTRL SOLN | EACH | Y | N | ||
| blood-glucose control, low | EASYMAX 15 | EACH | Y | N | ||
| blood-glucose control, low | UNISTRIP | EACH | Y | N | ||
| blood-glucose control, low | DIATRUE | EACH | Y | N | ||
| blood-glucose control, low | EASY PLUS II | EACH | Y | N | ||
| blood-glucose control, low | EASY TALK | EACH | Y | N | ||
| blood-glucose control, low | TRUE METRIX | EACH | Y | N | ||
| blood-glucose control, normal | EZ SMART | EACH | Y | N | ||
| blood-glucose control, normal | EASYMAX | EACH | Y | N | ||
| blood-glucose control, normal | ELEMENT COMPACT CONTROL SOLN | EACH | Y | N | ||
| blood-glucose control, normal | DIATRUE | EACH | Y | N | ||
| blood-glucose control, normal | FORACARE GDH | EACH | Y | N | ||
| blood-glucose control, normal | FREESTYLE CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | CHOICEDM CLARUS CONTROL SOLN | EACH | Y | N | ||
| blood-glucose control, normal | ACCU-CHEK SMARTVIEW | EACH | Y | N | ||
| blood-glucose control, normal | AGAMATRIX CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | BLOOD-GLUCOSE CONTROL | EACH | Y | N | ||
| blood-glucose control, normal | CARESENS | EACH | Y | N | ||
| blood-glucose control, normal | CLEVER CHOICE CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | CONTOUR NEXT CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | COOL CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | BREEZE 2 | EACH | Y | N | ||
| blood-glucose control, normal | GLUCOCARD EXPRESSION | EACH | Y | N | ||
| blood-glucose control, normal | RIGHTEST GT333 LEV 2 CTRL SOLN | EACH | Y | N | ||
| blood-glucose control, normal | SURE-TEST EASYPLUS MINI | EACH | Y | N | ||
| blood-glucose control, normal | TRUE METRIX | EACH | Y | N | ||
| blood-glucose control, normal | VIVAGUARD INO CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | TD GOLD LEVEL 2 CONTROL SOL | EACH | Y | N | ||
| blood-glucose control, normal | GLUCOCARD SHINE | EACH | Y | N | ||
| blood-glucose control, normal | GLUCOSE CONTROL | EACH | Y | N | ||
| blood-glucose control, normal | GOJJI GLUCOSE CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | INFINITY CONTROL SOLUTION | EACH | Y | N | ||
| blood-glucose control, normal | MEDISENSE | EACH | Y | N | ||
| blood-glucose control, normal | METER-CHECK | EACH | Y | N | ||
| blood-glucose control, normal | NOVA MAX GLUCOSE CONTROL SOLN | EACH | Y | N | ||
| blood-glucose control, normal | IHEALTH CONTROL SOLN LEVEL 2 | EACH | Y | N | ||
| blood-glucose meter | PRODIGY AUTOCODE | EACH | Y | N | ||
| blood-glucose meter | PRO VOICE V9 GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | PRO VOICE V8 GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | RELION MICRO | EACH | Y | N | ||
| blood-glucose meter | RELION PRIME | EACH | Y | N | ||
| blood-glucose meter | PREMIER BLU | EACH | Y | N | ||
| blood-glucose meter | PIP BLOOD GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | POGO AUTOMATIC BLOOD GLUC SYS | EACH | Y | N | ||
| blood-glucose meter | PREMIUM BLOOD GLUCOSE | EACH | Y | N | ||
| blood-glucose meter | PRESTO PRO | EACH | Y | N | ||
| blood-glucose meter | TRUE METRIX AIR GLUCOSE METER | EACH | Y | N | ||
| blood-glucose meter | SURE-TEST EASYPLUS MINI | EACH | Y | N | ||
| blood-glucose meter | TD GOLD VOICE GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | RIGHTEST GM250S METER | EACH | Y | N | ||
| blood-glucose meter | TRUE METRIX BLOOD GLUCOSE MTR | EACH | Y | N | ||
| blood-glucose meter | TRUE METRIX GO | EACH | Y | N | ||
| blood-glucose meter | FORA PREMIUM V10 | EACH | Y | N | ||
| blood-glucose meter | SMARTEST PERSONA | EACH | Y | N | ||
| blood-glucose meter | RIGHTEST GT333 GLUCOSE METER | EACH | Y | N | ||
| blood-glucose meter | SMART SENSE MONITORING SYSTEM | EACH | Y | N | ||
| blood-glucose meter | PHARMACIST CHOICE | EACH | Y | N | ||
| blood-glucose meter | GLUCOCARD EXPRESSION | EACH | Y | N | ||
| blood-glucose meter | GLUCOCARD SHINE | EACH | Y | N | ||
| blood-glucose meter | GE100 BLOOD GLUCOSE SYSTEM | EACH | Y | N | ||
| blood-glucose meter | FORA V30A | EACH | Y | N | ||
| blood-glucose meter | FORACARE GD20 | EACH | Y | N | ||
| blood-glucose meter | FORACARE GD40B | EACH | Y | N | ||
| blood-glucose meter | ONETOUCH VERIO FLEX METER | EACH | Y | N | ||
| blood-glucose meter | ONETOUCH VERIO IQ METER | EACH | Y | N | ||
| blood-glucose meter | ONETOUCH ULTRA2 | EACH | Y | N | ||
| blood-glucose meter | HEALTHPRO GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | ON CALL PLUS METER | EACH | Y | N | ||
| blood-glucose meter | GLUCOCARD SHINE EXPRESS METER | EACH | Y | N | ||
| blood-glucose meter | ULTIMA | EACH | Y | N | ||
| blood-glucose meter | ULTRATRAK PRO | EACH | Y | N | ||
| blood-glucose meter | ULTRATRAK ULTIMATE | EACH | Y | N | ||
| blood-glucose meter | VIVAGUARD INO SMART GLUC METER | EACH | Y | N | ||
| blood-glucose meter | VIVAGUARD INO GLUCOSE METER | EACH | Y | N | ||
| blood-glucose meter | FORA GD50 | EACH | Y | N | ||
| blood-glucose meter | FORA TEST N'GO VOICE | EACH | Y | N | ||
| blood-glucose meter | DIATRUE PLUS | EACH | Y | N | ||
| blood-glucose meter | CONTOUR NEXT ONE | EACH | Y | N | ||
| blood-glucose meter | CONTOUR NEXT EZ | EACH | Y | N | ||
| blood-glucose meter | EASY STEP | EACH | Y | N | ||
| blood-glucose meter | EASY TOUCH BLULINK GLUC SYST | EACH | Y | N | ||
| blood-glucose meter | CLEVER CHOICE MICRO | EACH | Y | N | ||
| blood-glucose meter | CONTOUR NEXT GEN | EACH | Y | N | ||
| blood-glucose meter | EASY TRAK II | EACH | Y | N | ||
| blood-glucose meter | CLEVER CHOICE TALK | EACH | Y | N | ||
| blood-glucose meter | CONTOUR NEXT | EACH | Y | N | ||
| blood-glucose meter | EVENCARE MINI MONITOR SYSTEM | EACH | Y | N | ||
| blood-glucose meter | EMBRACE TALK | EACH | Y | N | ||
| blood-glucose meter | EMBRACE WAVE PLUS GLUCOSE MTR | EACH | Y | N | ||
| blood-glucose meter | EASY TOUCH GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | EMBRACE | EACH | Y | N | ||
| blood-glucose meter | FORA G30A | EACH | Y | N | ||
| blood-glucose meter | EASYMAX V SPEAKING | EACH | Y | N | ||
| blood-glucose meter | EASYMAX NG | EACH | Y | N | ||
| blood-glucose meter | EASYMAX V2 | EACH | Y | N | ||
| blood-glucose meter | ELEMENT COMPACT | EACH | Y | N | ||
| blood-glucose meter | CARESENS S FIT GLUCOSE METER | EACH | Y | N | ||
| blood-glucose meter | ACCU-CHEK AVIVA PLUS | EACH | Y | N | ||
| blood-glucose meter | BIOTEL CARE BGM-4 | EACH | Y | N | ||
| blood-glucose meter | BLOOD GLUCOSE MONITOR | EACH | Y | N | ||
| blood-glucose meter | CARESENS N | EACH | Y | N | ||
| blood-glucose meter | CARESENS N FELIZ BT GLUCOS MTR | EACH | Y | N | ||
| blood-glucose meter | ASSURE PRISM MULTI | EACH | Y | N | ||
| blood-glucose meter | ADVOCATE REDI-CODE PLUS | EACH | Y | N | ||
| blood-glucose meter | ACCU-CHEK III | EACH | Y | N | ||
| blood-glucose meter | RELION ALL-IN-ONE | KIT | Y | N | ||
| blood-glucose meter | PRODIGY VOICE | KIT | Y | N | ||
| blood-glucose meter | RIGHTEST GM100 SYSTEM | KIT | Y | N | ||
| blood-glucose meter | PRODIGY | KIT | Y | N | ||
| blood-glucose meter | RIGHTEST GM300 SYSTEM | KIT | Y | N | ||
| blood-glucose meter | PREMIER COMPACT GLUCOSE METER | KIT | Y | N | ||
| blood-glucose meter | SMARTEST TALKING | KIT | Y | N | ||
| blood-glucose meter | RIGHTEST GM550 SYSTEM | KIT | Y | N | ||
| blood-glucose meter | SMART CARESENS N | KIT | Y | N | ||
| blood-glucose meter | SMARTEST EJECT | KIT | Y | N | ||
| blood-glucose meter | SMARTEST PERSONA | KIT | Y | N | ||
| blood-glucose meter | SMARTEST PRONTO | KIT | Y | N | ||
| blood-glucose meter | SMARTEST SMART CODE | KIT | Y | N | ||
| blood-glucose meter | FREESTYLE SIDEKICK II | KIT | Y | N | ||
| blood-glucose meter | GDRIVE | KIT | Y | N | ||
| blood-glucose meter | GE100 BLOOD GLUCOSE SYSTEM | KIT | Y | N | ||
| blood-glucose meter | GLUCO NAVII | KIT | Y | N | ||
| blood-glucose meter | FORA V10 | KIT | Y | N | ||
| blood-glucose meter | FORA V12 | KIT | Y | N | ||
| blood-glucose meter | FREESTYLE FLASH SYSTEM | KIT | Y | N | ||
| blood-glucose meter | FORA V20 | KIT | Y | N | ||
| blood-glucose meter | ON CALL PLUS METER | KIT | Y | N | ||
| blood-glucose meter | ON CALL VIVID METER | KIT | Y | N | ||
| blood-glucose meter | ON CALL VIVID PAL | KIT | Y | N | ||
| blood-glucose meter | ONETOUCH ULTRA2 | KIT | Y | N | ||
| blood-glucose meter | ONETOUCH VERIO REFLECT KIT | KIT | Y | N | ||
| blood-glucose meter | TRUETRACK SMART SYSTEM | KIT | Y | N | ||
| blood-glucose meter | GLUCOCOM BLOOD GLUCOSE | KIT | Y | N | ||
| blood-glucose meter | ON CALL EXPRESS METER | KIT | Y | N | ||
| blood-glucose meter | MICRO | KIT | Y | N | ||
| blood-glucose meter | MICRODOT | KIT | Y | N | ||
| blood-glucose meter | WAVESENSE PRESTO | KIT | Y | N | ||
| blood-glucose meter | CONTOUR NEXT GEN | KIT | Y | N | ||
| blood-glucose meter | CONTOUR NEXT EZ | KIT | Y | N | ||
| blood-glucose meter | EASY CHECK | KIT | Y | N | ||
| blood-glucose meter | CARETOUCH GLUCOSE MONITORING | KIT | Y | N | ||
| blood-glucose meter | CLEVER CHEK BLOOD GLUCOSE SYST | KIT | Y | N | ||
| blood-glucose meter | CONTOUR | KIT | Y | N | ||
| blood-glucose meter | EZ SMART | KIT | Y | N | ||
| blood-glucose meter | FORA D20 | KIT | Y | N | ||
| blood-glucose meter | EASYGLUCO | KIT | Y | N | ||
| blood-glucose meter | EASYGLUCO METER STARTER KIT | KIT | Y | N | ||
| blood-glucose meter | EASYMAX T1 | KIT | Y | N | ||
| blood-glucose meter | ELEMENT PLUS | KIT | Y | N | ||
| blood-glucose meter | EASYMAX NG | KIT | Y | N | ||
| blood-glucose meter | ACCU-CHEK | KIT | Y | N | ||
| blood-glucose meter | BLOOD GLUCOSE MONITORING | KIT | Y | N | ||
| blood-glucose meter | BLULINK DIABETIC TEST BUNDLE | KIT | Y | N | ||
| blood-glucose meter | CARESENS N PLUS BT | KIT | Y | N | ||
| blood-glucose meter | BLOOD-GLUCOSE METER | KIT | Y | N | ||
| blood-glucose meter | ACCU-CHEK SIMPLICITY | KIT | Y | N | ||
| blood-glucose meter | ADVANCED ALL-IN-ONE METER | KIT | Y | N | ||
| blood-glucose meter | AT-LAST | KIT | Y | N | ||
| blood-glucose meter | AGAMATRIX JAZZ WIRELESS 2 | KIT | Y | N | ||
| inhaler, assist devices | WINDMILL TRAINER | SPACER | Y | N | ||
| inhaler, assist devices | AEROCHAMBER Z-STAT PLUS | SPACER | Y | N | ||
| inhaler, assist devices | AEROCHAMBER MV | SPACER | Y | N | ||
| inhaler, assist devices | AEROCHAMBER MECHANICAL VENT | SPACER | Y | N | ||
| inhaler, assist devices | ACE AEROSOL CLOUD ENHANCER | SPACER | Y | N | ||
| inhaler, assist devices | EASIVENT | SPACER | Y | N | ||
| inhaler, assist devices | BREATHRITE | SPACER | Y | N | ||
| inhaler, assist devices | AEROVENT PLUS | SPACER | Y | N | ||
| inhaler, assist devices | AEROTRACH PLUS | SPACER | Y | N | ||
| inhaler, assist devices | AEROCHAMBER2GO | SPACER | Y | N | ||
| inhaler, assist devices | VORTEX | SPACER | Y | N | ||
| inhaler, assist devices | RITEFLO | SPACER | Y | N | ||
| inhaler, assist devices | PRIMEAIRE | SPACER | Y | N | ||
| inhaler, assist devices | OPTICHAMBER DIAMOND | SPACER | Y | N | ||
| lancets | SOLUS V2 LANCETS | EACH | Y | N | ||
| lancets | MONOLET LANCETS | EACH | Y | N | ||
| lancets | MICRO THIN LANCET | EACH | Y | N | ||
| lancets | MICRODOT SAFETY LANCET | EACH | Y | N | ||
| lancets | MEDISENSE THIN LANCETS | EACH | Y | N | ||
| lancets | LITE TOUCH | EACH | Y | N | ||
| lancets | MYGLUCOHEALTH LANCETS | EACH | Y | N | ||
| lancets | NOVA SUREFLEX | EACH | Y | N | ||
| lancets | ON CALL PLUS LANCET | EACH | Y | N | ||
| lancets | GOJJI LANCETS | EACH | Y | N | ||
| lancets | FORA LANCETS | EACH | Y | N | ||
| lancets | FREESTYLE LANCETS | EACH | Y | N | ||
| lancets | MEDLANCE PLUS | EACH | Y | N | ||
| lancets | ONETOUCH DELICA SAFETY LANCET | EACH | Y | N | ||
| lancets | INCONTROL SUPER THIN LANCETS | EACH | Y | N | ||
| lancets | INJECT EASE LANCETS | EACH | Y | N | ||
| lancets | LANCETS | EACH | Y | N | ||
| lancets | SINGLE-LET | EACH | Y | N | ||
| lancets | RELIAMED SAFETY SEAL LANCETS | EACH | Y | N | ||
| lancets | RIGHTEST GL300 LANCETS | EACH | Y | N | ||
| lancets | ONETOUCH DELICA | EACH | Y | N | ||
| lancets | PUSH BUTTON SAFETY LANCET | EACH | Y | N | ||
| lancets | SMART SENSE LANCETS | EACH | Y | N | ||
| lancets | SOFT TOUCH | EACH | Y | N | ||
| lancets | SOLUS V2 | EACH | Y | N | ||
| lancets | PRO COMFORT LANCETS | EACH | Y | N | ||
| lancets | ONETOUCH LANCETS | EACH | Y | N | ||
| lancets | ON-THE-GO | EACH | Y | N | ||
| lancets | PIP LANCET | EACH | Y | N | ||
| lancets | PRO COMFORT LANCET | EACH | Y | N | ||
| lancets | PRO COMFORT SAFETY LANCET | EACH | Y | N | ||
| lancets | PRODIGY TWIST TOP LANCET | EACH | Y | N | ||
| lancets | PURE COMFORT SAFETY LANCETS | EACH | Y | N | ||
| lancets | PRESSURE ACTIVATED LANCETS | EACH | Y | N | ||
| lancets | FINGERSTIX | EACH | Y | N | ||
| lancets | ACTI-LANCE | EACH | Y | N | ||
| lancets | ADVOCATE LANCET | EACH | Y | N | ||
| lancets | ADVOCATE SAFETY LANCET | EACH | Y | N | ||
| lancets | ALTERNATE SITE LANCETS | EACH | Y | N | ||
| lancets | ASSURE LANCE | EACH | Y | N | ||
| lancets | AT-LAST LANCETS | EACH | Y | N | ||
| lancets | ADVOCATE LANCETS | EACH | Y | N | ||
| lancets | 2-IN-1 LANCET DEVICE | EACH | Y | N | ||
| lancets | DROPSAFE ACTI-LANCE | EACH | Y | N | ||
| lancets | DROPSAFE HAEMOLANCE PLUS | EACH | Y | N | ||
| lancets | DROPSAFE MEDLANCE PLUS | EACH | Y | N | ||
| lancets | EASY TOUCH | EACH | Y | N | ||
| lancets | EMBRACE | EACH | Y | N | ||
| lancets | E-Z JECT LANCETS | EACH | Y | N | ||
| lancets | E-ZJECT LANCETS | EACH | Y | N | ||
| lancets | EASY COMFORT LANCETS | EACH | Y | N | ||
| lancets | CARESENS | EACH | Y | N | ||
| lancets | CARETOUCH SAFETY LANCETS | EACH | Y | N | ||
| lancets | DROPLET MEDLANCE PLUS | EACH | Y | N | ||
| lancets | DROPLET LANCETS | EACH | Y | N | ||
| lancets | COLOR LANCETS | EACH | Y | N | ||
| lancets | COMFORT LANCETS | EACH | Y | N | ||
| lancets | BULLSEYE MINI SAFETY LANCETS | EACH | Y | N | ||
| lancets | STERILANCE TL | EACH | Y | N | ||
| lancets | VIVAGUARD SAFETY LANCET | EACH | Y | N | ||
| lancets | VITALET PRO PLUS | EACH | Y | N | ||
| lancets | VITALET | EACH | Y | N | ||
| lancets | UNISTIK TOUCH | EACH | Y | N | ||
| lancets | UNISTIK PRO | EACH | Y | N | ||
| lancets | UNISTIK EXTRA | EACH | Y | N | ||
| lancets | UNISTIK COMFORT | EACH | Y | N | ||
| lancets | ULTILET BASIC | EACH | Y | N | ||
| lancets | TWIST LANCETS | EACH | Y | N | ||
| lancets | TRUEPLUS LANCET | EACH | Y | N | ||
| lancets | TRUE COMFORT LANCET | EACH | Y | N | ||
| lancets | UNISTIK 3 NORMAL | EACH | Y | N | ||
| lancets | ULTILET SAFETY | EACH | Y | N | ||
| lancets | SURE COMFORT LANCETS | EACH | Y | N | ||
| lancets | SURE-TOUCH | EACH | Y | N | ||
| lancets | TELCARE | EACH | Y | N | ||
| lancets | ULTRATLC LANCETS | EACH | Y | N | ||
| lancets | UNISTIK 2 NORMAL | EACH | Y | N | ||
| lancets | UNISTIK 2 COMFORT | EACH | Y | N | ||
| lancets | UNILET LANCET | EACH | Y | N | ||
| lancets | UNILET EXCELITE II | EACH | Y | N | ||
| lancets | UNILET COMFORTOUCH | EACH | Y | N | ||
| lancets | ULTRATLC | EACH | Y | N | ||
| lancets | ULTRALANCE | EACH | Y | N | ||
| lancets | ULTRA THIN PLUS LANCETS | EACH | Y | N | ||
| lancets | ULTRA THIN LANCET | EACH | Y | N | ||
| lancets | UNISTIK 3 DUAL | EACH | Y | N | ||
| lancets | UNISTIK 3 COMFORT | EACH | Y | N | ||
| lancing device | INCONTROL LANCING DEVICE | EACH | Y | N | ||
| lancing device | ADVOCATE RAPID-SAFE LANCING DV | EACH | Y | N | ||
| lancing device | ALTERNATE SITE LANCING DEVICE | EACH | Y | N | ||
| lancing device | CARESOFT LANCING DEVICE | EACH | Y | N | ||
| lancing device | GOJJI LANCING DEVICE | EACH | Y | N | ||
| lancing device | EMBRACE LANCING DEVICE | EACH | Y | N | ||
| lancing device | EASY MINI EJECT LANCING DEVICE | EACH | Y | N | ||
| lancing device | DROPLET GENTEEL LANCING DEVICE | EACH | Y | N | ||
| lancing device | CARETOUCH LANCING DEVICE | EACH | Y | N | ||
| lancing device | CARESENS PREM LANCING DEVICE | EACH | Y | N | ||
| lancing device | CARELANCE ULT LANCING DEVICE | EACH | Y | N | ||
| lancing device | AUTOLET LITE | EACH | Y | N | ||
| lancing device | AUTO-LANCET MINI | EACH | Y | N | ||
| lancing device | CHOSEN LANCING DEVICE | EACH | Y | N | ||
| lancing device | ULTI-LANCE | EACH | Y | N | ||
| lancing device | ON CALL LANCING DEVICE | EACH | Y | N | ||
| lancing device | SURE-PEN | EACH | Y | N | ||
| lancing device | RIGHTEST GD500 | EACH | Y | N | ||
| lancing device | PRODIGY LANCING DEVICE | EACH | Y | N | ||
| lancing device | LANCING SYSTEM | EACH | Y | N | ||
| lancing device | SOFTCLIX | EACH | Y | N | ||
| lancing device | SURE COMFORT LANCING PEN | EACH | Y | N | ||
| lancing device/lancets | ACCU-CHEK SOFTCLIX | KIT | Y | N | ||
| lancing device/lancets | ACCU-CHEK | KIT | Y | N | ||
| lancing device/lancets | ADVANCED LANCING DEVICE | KIT | Y | N | ||
| lancing device/lancets | ULTI-LANCE | KIT | Y | N | ||
| lancing device/lancets | SOLUS V2 LANCING DEVICE | KIT | Y | N | ||
| lancing device/lancets | HYPOLANCE | KIT | Y | N | ||
| lancing device/lancets | MULTI-LANCET | KIT | Y | N | ||
| lancing device/lancets | AUTOLET IMPRESSION | KIT | Y | N | ||
| lancing device/lancets | LANZO | KIT | Y | N | ||
| lancing device/lancets | UNISTIK 2 | KIT | Y | N | ||
| pen needle, diabetic | ULTRA-THIN II | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | VERIFINE PLUS PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | UNIFINE ULTRA PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | UNIFINE PENTIPS | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | UNIFINE OTC PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | ULTRA-FINE SHORT PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | ULTRA-FINE ORIGINAL PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | ULTRA-FINE MINI PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | ULTRACARE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | UNIFINE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | EASY TOUCH PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | MICRODOT INSULIN PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | LITE TOUCH | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | INSULIN PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | HEALTHY ACCENTS UNIFINE PENTIP | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | EMBRACE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | EASY GLIDE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | EASY COMFORT PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | COMFORT TOUCH PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | CLICKFINE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | HEALTHWISE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | ULTICARE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | TRUE COMFORT PRO PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | TOPCARE CLICKFINE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | NANO PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | NOVOFINE 32 | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | SIMPLI PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | PRO COMFORT PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | PENTIPS PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | TECHLITE PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | NANO 2ND GEN PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | AQINJECT PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | 1ST TIER UNIFINE PENTIPS | DIS NEEDLE | Y | N | ||
| pen needle, diabetic | PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic, safety | HEALTHY ACCENTS UNIFINE PENTIP | DIS NEEDLE | Y | N | ||
| pen needle, diabetic, safety | MAXICOMFORT SAFETY PEN NEEDLE | DIS NEEDLE | Y | N | ||
| pen needle, diabetic,disp unit | ULTIGUARD SAFEPACK-PEN NEEDLE | DIS NEEDLE | Y | N | ||
| syr,ndl 1 mL,ins,safe,disp unt | SAFESNAP INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syr,ndl,insulin,1mL-sharps bin | ULTIGUARD SAFEPACK-INSULIN SYR | SYRINGE | Y | N | ||
| syrge-ndl,ins 0.3 mL half mark | INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | EASY TOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | SURE-JECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | PRODIGY INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | LITETOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | ELITE-THIN | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | EASY TOUCH | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | EASY COMFORT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | COMFORT EZ INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | ADVOCATE SYRINGES | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | HEALTHWISE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | TERUMO INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | ULTRA-FINE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | ULTRA FLO INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | ULTILET INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syring-needl,disp,insul,0.3 mL | TRUEPLUS INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | MAXI-COMFORT | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | TERUMO INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | SURE-JECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | SAFETYGLIDE SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | PRO COMFORT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | MAXICOMFORT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | LITETOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | FREESTYLE PRECISION | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | ELITE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | MONOJECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | THINPRO INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | EASY TOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | ULTRA-FINE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | ULTRA COMFORT | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | ULTICARE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | TRUE COMFORT PRO INS SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | EASY TOUCH | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | EASY COMFORT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | COMFORT EZ INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | ADVOCATE SYRINGES | DISP SYRIN | Y | N | ||
| syringe and needle,insulin,1mL | MONOJECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe with needle, insulin | ULTRA COMFORT | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | ULTRA-THIN II | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | COMFORT EZ INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | HEALTHWISE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | ELITE-THIN | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | EASY TOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | EASY GLIDE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | DROPLET INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | CARETOUCH INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | EASY COMFORT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | ULTRACARE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | ULTRA COMFORT | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | ULTICARE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | INSULIN SYRINGE W/NEEDLE DISP | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | LITE TOUCH | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | SURE COMFORT | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | PRODIGY INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | MONOJECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | MAXI-COMFORT | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | TRUE COMFORT PRO INS SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | THINPRO INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | MONOJECT INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe-needle,insulin,0.5 mL | INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe,insul U-500,ndl,0.5mL | INSULIN SYRINGE U-500 | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,safe,1mL | SAFETYGLIDE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,safe,1mL | EASY TOUCH SHEATHLOCK INSULIN | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,safe,1mL | EASY TOUCH FLIPLOCK INSULIN | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,safe,1mL | TRUE COMFORT SAFE INSULIN SYRG | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,safe,1mL | DROPSAFE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf 0.5mL | ASSURE ID INSULIN SAFETY | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf 0.5mL | SECURESAFE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf 0.5mL | EASY TOUCH INSULIN SAFETY | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf 0.5mL | MAGELLAN INSULIN SAFETY SYRNG | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf,0.3mL | SAFETYGLIDE INSULIN SYRINGE | DISP SYRIN | Y | N | ||
| syringe,needle,insuln,sf,0.3mL | MAGELLAN INSULIN SAFETY SYRNG | DISP SYRIN | Y | N |