Diagnostics
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.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Carveout ‐ Bill FFS |
Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|---|
| 16714055601 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 16714099701 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 23155025831 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 23155025832 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 25021031802 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 25021031804 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 55150019201 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 55150019301 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065100 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065101 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065102 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065104 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065120 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 63323065130 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085400 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085404 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085500 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085502 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085620 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 67457085730 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 71288020720 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 71288020721 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 71288020830 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 72078003300 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 72078003302 | ADENOSINE | adenosine | VIAL | 3 mg/mL | Y | N | ||
| 59137023101 | GLEOLAN | aminolevulinic acid HCl | SOLN RECON | 30 mg/mL | Y | N | ||
| 00224062306 | EPI-STAT-57 | barium sulfate | ORAL SUSP | 57 % | Y | N | ||
| 00224062307 | EPI-STAT-57 | barium sulfate | ORAL SUSP | 57 % | Y | N | ||
| 00224062319 | EPI-STAT-57 | barium sulfate | ORAL SUSP | 57 % | Y | N | ||
| 00224062406 | EPI-STAT-61 | barium sulfate | ORAL SUSP | 61 % | Y | N | ||
| 00224062407 | EPI-STAT-61 | barium sulfate | ORAL SUSP | 61 % | Y | N | ||
| 00224062419 | EPI-STAT-61 | barium sulfate | ORAL SUSP | 61 % | Y | N | ||
| 00224062106 | BAROSPERSE | barium sulfate | POWDER | 95 % | Y | N | ||
| 00224062690 | BAROSPERSE-110 | barium sulfate | POWDER | 95 % | Y | N | ||
| 53885029901 | ONE TOUCH/ONE TOUCH II | blood sugar diagnostic | KIT | Y | N | N | ||
| 50924014110 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924056050 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924056610 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924087710 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000560 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000566 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000877 | ACCU-CHEK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 54868082400 | ACCU-CHEK ADVANTAGE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702040710 | ACCU-CHEK AVIVA PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702040810 | ACCU-CHEK AVIVA PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702070195 | ACCU-CHEK GUIDE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702071010 | ACCU-CHEK GUIDE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702071110 | ACCU-CHEK GUIDE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702071210 | ACCU-CHEK GUIDE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702071910 | ACCU-CHEK GUIDE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924031410 | ACCU-CHEK SIMPLICITY | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537030276 | ACCU-CHEK SIMPLICITY | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537030314 | ACCU-CHEK SIMPLICITY | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702049210 | ACCU-CHEK SMARTVIEW | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702049310 | ACCU-CHEK SMARTVIEW | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702027410 | ACCUTREND GLUCOSE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 65702045610 | ACCUTREND GLUCOSE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317410000 | ADVANCE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317415050 | ADVANCE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482041050 | ADVANCE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482041100 | ADVANCE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50428046735 | ADVANCED GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50428054214 | ADVANCED GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500375 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500475 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500575 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500675 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50428049095 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50428049173 | ADVANCED GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000113 | ADVOCATE REDI-CODE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000124 | ADVOCATE REDI-CODE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000126 | ADVOCATE REDI-CODE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000133 | ADVOCATE REDI-CODE+ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000139 | ADVOCATE REDI-CODE+ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000157 | ADVOCATE REDI-CODE+ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000187 | ADVOCATE REDI-CODE+ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94046000100 | ADVOCATE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554403601 | AGAMATRIX AMP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554232001 | AGAMATRIX JAZZ TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554318802 | AGAMATRIX JAZZ TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554332901 | AGAMATRIX PRESTO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554333702 | AGAMATRIX PRESTO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85541007410 | AGAMATRIX PRESTO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317560050 | ASSURE 4 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317560100 | ASSURE 4 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482056050 | ASSURE 4 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482056100 | ASSURE 4 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317500050 | ASSURE PLATINUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317500100 | ASSURE PLATINUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482050050 | ASSURE PLATINUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482050100 | ASSURE PLATINUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317502030 | ASSURE PLATINUM TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317530050 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317530101 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317532050 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482053050 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482053100 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482053250 | ASSURE PRISM MULTI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08238054702 | AT-LAST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08238117104 | AT-LAST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66852000547 | AT-LAST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66852001171 | AT-LAST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500326 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500426 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500444 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500526 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500544 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500622 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500644 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500691 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500744 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500791 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500844 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500891 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554424001 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08626100750 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08626333350 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045505 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045506 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045507 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045511 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13757046480 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 49035038600 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50070097934 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 81131010486 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295011716 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295011717 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012208 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012210 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012211 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012915 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012916 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295012917 | BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 68196040105 | BLULINK GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 68196040110 | BLULINK GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08617155104 | CARESENS N | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08617164104 | CARESENS N | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08617187104 | CARESENS N | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554010974 | CARESENS S TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08554010976 | CARESENS S TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85325000100 | CARESENS S TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 70393000142 | CARETOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 70393021105 | CARETOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924050125 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924050250 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50924050810 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000501 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000502 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000508 | CHEMSTRIP BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89105200001 | CHOICEDM CLARUS TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000170 | CLEVER CHOICE MICRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000128 | CLEVER CHOICE PRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000191 | CLEVER CHOICE TALK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000102 | CLEVER CHOICE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000108 | CLEVER CHOICE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302013942 | CLEVER CHOICE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302139142 | CLEVER CHOICE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000118 | CLEVER CHOICE VOICE+ TST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000120 | CLEVER CHOICE VOICE+ TST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193727735 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193727870 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193730850 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193731025 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193731150 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193731221 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193731310 | CONTOUR NEXT TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193758450 | CONTOUR PLUS TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193707025 | CONTOUR TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193708050 | CONTOUR TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193709021 | CONTOUR TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08617194104 | COOL GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50065000606 | DARIO BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50065000607 | DARIO BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193288821 | DEXTROSTIX REAGENT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91984000142 | DIATRUE PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91237000101 | EASY CHECK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91237000164 | EASY PLUS II | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91237000119 | EASY STEP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91237000148 | EASY TALK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50027049422 | EASY TALK PLUS II | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496701501 | EASY TOUCH BLULINK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496080705 | EASY TOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496081905 | EASY TOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 68196080705 | EASY TOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 78742023461 | EASY TOUCH TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 91237000142 | EASY TRAK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50632000737 | EASY TRAK II TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08463020350 | EASYGLUCO TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08463120350 | EASYGLUCO TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85502000203 | EASYGLUCO TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85502000213 | EASYGLUCO TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 47884017550 | EASYMAX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85017000001 | EASYMAX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 47884017615 | EASYMAX 15 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85017000041 | EASYMAX 15 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08522000068 | ELEMENT COMPACT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08522000023 | ELEMENT TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000202 | EMBRACE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000233 | EMBRACE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000235 | EMBRACE EVO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000240 | EMBRACE PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000280 | EMBRACE PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000299 | EMBRACE PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000270 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000271 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000272 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000283 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000291 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000294 | EMBRACE TALK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000221 | EMBRACE WAVE GLUCOSE TEST STRP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 94030000250 | EMBRACE WAVE GLUCOSE TEST STRP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 80196073463 | EVENCARE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08327006109 | EVENCARE G2 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 84389010256 | EVENCARE G2 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08327052509 | EVENCARE G3 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 84389083120 | EVENCARE G3 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08327009129 | EVENCARE MINI GLUCOSE TEST STR | blood sugar diagnostic | STRIP | Y | N | N | ||
| 84389017674 | EVENCARE MINI GLUCOSE TEST STR | blood sugar diagnostic | STRIP | Y | N | N | ||
| 88277040917 | EVENCARE PROVIEW TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08522000017 | EVOLUTION TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599872901 | EXACTECH | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599873001 | EXACTECH | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53459000072 | EZ SMART | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53459000100 | EZ SMART | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53459001727 | EZ SMART | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53459001737 | EZ SMART | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53459000077 | EZ SMART PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 92896000009 | FIFTY50 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001307 | FORA 6 CONNECT GLUCOSE STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001311 | FORA 6CONN-GTEL-TN'G ADV STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000238 | FORA D15G | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000245 | FORA D20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001166 | FORA D40-G31 TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001024 | FORA G20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000234 | FORA G20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000231 | FORA G30-PREMIUM V10 TEST STRP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001122 | FORA GD50 TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001339 | FORA GTEL GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001026 | FORA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001040 | FORA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001365 | FORA TN'G ADVAN PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001366 | FORA TN'G ADVAN PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001198 | FORA TN'G VOICE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001020 | FORA V10 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000236 | FORA V10 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001202 | FORA V10-V12-D10-D20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000201 | FORA V10-V12-D10-D20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001095 | FORA V12 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000227 | FORA V12 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000218 | FORA V20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98939000260 | FORA V30A | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001018 | FORACARE GD20 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001055 | FORACARE GD40 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 47884017450 | FORTISCARE G1 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 47884017850 | FORTISCARE GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073071230 | FREESTYLE INSULINX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073071231 | FREESTYLE INSULINX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073071227 | FREESTYLE INSULINX TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073071229 | FREESTYLE INSULINX TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073070823 | FREESTYLE LITE STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073070819 | FREESTYLE LITE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073070822 | FREESTYLE LITE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073070827 | FREESTYLE LITE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073071026 | FREESTYLE LITE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599157701 | FREESTYLE PRECISION NEO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599157904 | FREESTYLE PRECISION NEO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815071577 | FREESTYLE PRECISION NEO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815071579 | FREESTYLE PRECISION NEO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073012050 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073012101 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073012301 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073012401 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073012450 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 99073070792 | FREESTYLE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539810000 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539810001 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539810002 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539810003 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 83489000075 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 83489000076 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 83489000077 | GE100 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539391201 | GE333 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539391502 | GE333 BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89145010050 | GENSTRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89145020050 | GENSTRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 67396000032 | GENULTIMATE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 69861010010 | GENULTIMATE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 69861010050 | GENULTIMATE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87473000002 | GLUCO NAVII | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87473000011 | GLUCO NAVII | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87473000012 | GLUCO NAVII | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317720050 | GLUCOCARD 01 SENSOR PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317740050 | GLUCOCARD 01 SENSOR PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482072050 | GLUCOCARD 01 SENSOR PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482074050 | GLUCOCARD 01 SENSOR PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317570050 | GLUCOCARD EXPRESSION | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317572050 | GLUCOCARD EXPRESSION | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482057005 | GLUCOCARD EXPRESSION | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482057205 | GLUCOCARD EXPRESSION | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317540050 | GLUCOCARD SHINE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482054050 | GLUCOCARD SHINE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317760050 | GLUCOCARD VITAL | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482076050 | GLUCOCARD VITAL | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317762050 | GLUCOCARD VITAL SENSOR | blood sugar diagnostic | STRIP | Y | N | N | ||
| 15482076205 | GLUCOCARD VITAL SENSOR | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08525010150 | GLUCOCOM GLUCOSE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193237021 | GLUCOFILM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193237150 | GLUCOFILM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193237225 | GLUCOFILM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917005075 | GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917005076 | GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193237321 | GLUCOSTIX REAGENT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193237525 | GLUCOSTIX REAGENT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50001046232 | GOJJI BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89154000059 | GOODLIFE AC-302 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 88277067568 | HARMONY GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496080902 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496080905 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08496080910 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 41260000726 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 41260000727 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 41260000728 | HEALTHPRO GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539291501 | IGLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 83489031033 | IGLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56362000519 | IHEALTH GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08463520350 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08463820350 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000600 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000601 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000602 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000603 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000604 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000605 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000606 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000607 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000608 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000609 | INFINITY TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57513000639 | INFINITY VOICE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317710050 | MICRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 51028000175 | MICRODOT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 52422010050 | MICRODOT | blood sugar diagnostic | STRIP | Y | N | N | ||
| 52422020050 | MICRODOT XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50081000301 | MYGLUCOHEALTH | blood sugar diagnostic | STRIP | Y | N | N | ||
| 59108000301 | NEUTEK 2TEK TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 59108000302 | NEUTEK 2TEK TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89128010001 | NEUTEK 2TEK TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89128015001 | NEUTEK 2TEK TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08548043416 | NOVA MAX GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08548043423 | NOVA MAX GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08548043437 | NOVA MAX GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08548043523 | NOVA MAX GLUCOSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 82607055729 | ON CALL EXPRESS TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 82607053521 | ON CALL PLUS TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 82607055622 | ON CALL VIVID TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 82607055625 | ON CALL VIVID TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885000971 | ONETOUCH ULTRA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885000972 | ONETOUCH ULTRA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885024450 | ONETOUCH ULTRA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885024510 | ONETOUCH ULTRA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885099425 | ONETOUCH ULTRA TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885000773 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885000975 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885000976 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885001218 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885001278 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885027025 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885027150 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885027210 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53885032850 | ONETOUCH VERIO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599913404 | OPTIUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599913505 | OPTIUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099134 | OPTIUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099135 | OPTIUM | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599104104 | OPTIUM EZ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599104205 | OPTIUM EZ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815071041 | OPTIUM EZ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815071042 | OPTIUM EZ | blood sugar diagnostic | STRIP | Y | N | N | ||
| 82607053925 | OPTUMRX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 98302000133 | PHARMACIST CHOICE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 32671010941 | PIP BLOOD GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 81131040327 | PLATINUM TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 81131040328 | PLATINUM TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599875705 | PRECISION PCX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599956505 | PRECISION PCX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815098757 | PRECISION PCX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099565 | PRECISION PCX | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599006305 | PRECISION PCX PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599033901 | PRECISION PCX PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815080063 | PRECISION PCX PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815080339 | PRECISION PCX PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599011605 | PRECISION POINT OF CARE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815080116 | PRECISION POINT OF CARE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599740105 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599833501 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599833601 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599873201 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599873204 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599873301 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599873305 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815097401 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815098335 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815098336 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815098732 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815098733 | PRECISION Q-I-D | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599969405 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599969504 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599972804 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599983804 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599987705 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 57599987805 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099694 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099695 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099728 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099838 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099877 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 93815099878 | PRECISION XTRA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317780025 | PREMIER TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317780050 | PREMIER TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317780100 | PREMIER TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045509 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 13733045510 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 36800036744 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 36800036745 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 36800036746 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 41260036069 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 41260036070 | PREMIUM BLOOD GLUCOSE TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001059 | PREMIUM V10 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001274 | PRO VOICE V8-V9 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08484052800 | PRODIGY NO CODING | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08484072500 | PRODIGY NO CODING | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08484073200 | PRODIGY NO CODING | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08484075300 | PRODIGY NO CODING | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08193271301 | PTS PANELS EGLU TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89115005102 | QUINTET | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89115005902 | QUINTET AC | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87701066838 | REAGENT STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87701066840 | REAGENT STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 37654049727 | REFUAH PLUS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 05388056447 | RELION CONFIRM-MICRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 05388086017 | RELION CONFIRM-MICRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317712020 | RELION CONFIRM-MICRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317712100 | RELION CONFIRM-MICRO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317700025 | RELION PRIME TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317700050 | RELION PRIME TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08317700100 | RELION PRIME TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 10585086504 | REVEAL TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89137050050 | REVEAL TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539105002 | RIGHTEST GS100 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539310002 | RIGHTEST GS250S TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539260001 | RIGHTEST GS260 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539000501 | RIGHTEST GS300 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539505003 | RIGHTEST GS550 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539492003 | RIGHTEST GS700 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539497201 | RIGHTEST GS700 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539392101 | RIGHTEST GT333 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539392203 | RIGHTEST GT333 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539392502 | RIGHTEST GT333 TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539498102 | RIGHTEST MAX TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08539498201 | RIGHTEST MAX TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500425 | SMART SENSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500525 | SMART SENSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500625 | SMART SENSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500725 | SMART SENSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08396500825 | SMART SENSE TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08524000103 | SMARTEST TEST | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08611503050 | SOLUS V2 TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 59707000156 | SURE-TEST EASYPLUS MINI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 59707055001 | SURE-TEST EASYPLUS MINI | blood sugar diagnostic | STRIP | Y | N | N | ||
| 47884018050 | TD GOLD TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85017000017 | TD GOLD TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 59519000201 | TELCARE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 16042001088 | TEST N'GO | blood sugar diagnostic | STRIP | Y | N | N | ||
| 62850000022 | TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87701033674 | TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 75537000535 | TRACER BG | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08528146404 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917016690 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000616 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000617 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000618 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000619 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000717 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000720 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000749 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 50428059453 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146001 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146003 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146004 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146101 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146104 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146304 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146401 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146404 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146704 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87701042626 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 96295014204 | TRUE METRIX GLUCOSE TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000621 | TRUE METRIX PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151146604 | TRUE METRIX PRO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917009960 | TRUETEST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917009961 | TRUETEST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917011158 | TRUETEST TEST STRIPS | blood sugar diagnostic | STRIP | Y | N | N | ||
| 11917010488 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 21292000291 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151081001 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151081350 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151082525 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 56151085050 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 87701040542 | TRUETRACK TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66004097309 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66004602909 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66004603004 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 66004603105 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 81131006029 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 81131006030 | ULTIMA | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08593211002 | ULTRATRAK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 85930001101 | ULTRATRAK | blood sugar diagnostic | STRIP | Y | N | N | ||
| 08593212002 | ULTRATRAK ULTIMATE | blood sugar diagnostic | STRIP | Y | N | N | ||
| 89167024850 | UNISTRIP1 | blood sugar diagnostic | STRIP | Y | N | N | ||
| 40423050001 | VIVAGUARD INO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 40423050002 | VIVAGUARD INO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53483000801 | VIVAGUARD INO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53483000818 | VIVAGUARD INO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 53483000820 | VIVAGUARD INO TEST STRIP | blood sugar diagnostic | STRIP | Y | N | N | ||
| 00193967430 | BREEZE 2 | blood sugar diagnostic, disc | STRIP | Y | N | N | ||
| 69945006401 | DETECTNET | copper Cu-64 dotatate | VIAL | 148 MBq/4 mL (4 mCi/4 mL) | Y | N | ||
| 31722001912 | DIATRIZOATE MEGLUMINE-SODIUM | diatrizoate meglumine, sodium | SOLUTION | 66 %-10 % | Y | N | ||
| 31722001930 | DIATRIZOATE MEGLUMINE-SODIUM | diatrizoate meglumine, sodium | SOLUTION | 66 %-10 % | Y | N | ||
| 31722001931 | DIATRIZOATE MEGLUMINE-SODIUM | diatrizoate meglumine, sodium | SOLUTION | 66 %-10 % | Y | N | ||
| 31722001932 | DIATRIZOATE MEGLUMINE-SODIUM | diatrizoate meglumine, sodium | SOLUTION | 66 %-10 % | Y | N | ||
| 00409204302 | DIPYRIDAMOLE | dipyridamole | AMPUL | 5 mg/mL | Y | N | ||
| 11994000525 | PERSANTINE I.V. | dipyridamole | AMPUL | 5 mg/mL | Y | N | ||
| 00641256941 | DIPYRIDAMOLE | dipyridamole | VIAL | 5 mg/mL | Y | N | ||
| 00641256944 | DIPYRIDAMOLE | dipyridamole | VIAL | 5 mg/mL | Y | N | ||
| 59338070355 | FERIDEX I.V. | ferumoxides | VIAL | 11.2 mg iron/mL | Y | N | ||
| 00002120001 | AMYVID | florbetapir F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 00002120048 | AMYVID | florbetapir F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 00002120050 | AMYVID | florbetapir F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 00002121030 | TAUVID | flortaucipir F-18 | VIAL | 370 MBq (10 mCi) | Y | N | ||
| 00002121050 | TAUVID | flortaucipir F-18 | VIAL | 370 MBq (10 mCi) | Y | N | ||
| 00002122001 | TAUVID PATIENT READY DOSE | flortaucipir F-18 | VIAL | 370 MBq (10 mCi) | Y | N | ||
| 69932000201 | POSLUMA | flotufolastat F 18 gallium | VIAL | 296 MBq/mL to 5,846 MBq/mL (8 mCi/mL to 158 mCi/mL) | Y | N | ||
| 69932000250 | POSLUMA | flotufolastat F 18 gallium | VIAL | 296 MBq/mL to 5,846 MBq/mL (8 mCi/mL to 158 mCi/mL) | Y | N | ||
| 69932000101 | AXUMIN | fluciclovine F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 69932000130 | AXUMIN | fluciclovine F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 69932000150 | AXUMIN | fluciclovine F-18 | VIAL | 10 mCi (370 MBq) | Y | N | ||
| 00065078112 | FLUORESCEIN SODIUM | fluorescein sodium | DROPS | 2 % | Y | N | ||
| 51801000301 | GLOSTRIPS | fluorescein sodium | STRIP | 0.6 mg | Y | N | ||
| 51801000340 | GLOSTRIPS | fluorescein sodium | STRIP | 0.6 mg | Y | N | ||
| 51801000350 | GLOSTRIPS | fluorescein sodium | STRIP | 0.6 mg | Y | N | ||
| 24208039183 | FLUOR-I-STRIP AT | fluorescein sodium | STRIP | 1 mg | Y | N | ||
| 51801000901 | GLOSTRIPS | fluorescein sodium | STRIP | 1 mg | Y | N | ||
| 51801000940 | GLOSTRIPS | fluorescein sodium | STRIP | 1 mg | Y | N | ||
| 14789012305 | FLUORESCEIN SODIUM | fluorescein sodium | VIAL | 500 mg/2 mL (25 %) | Y | N | ||
| 14789012307 | FLUORESCEIN SODIUM | fluorescein sodium | VIAL | 500 mg/2 mL (25 %) | Y | N | ||
| 81298866001 | AK-FLUOR | fluorescein sodium | VIAL | 500 mg/5 mL (10 %) | Y | N | ||
| 81298866003 | AK-FLUOR | fluorescein sodium | VIAL | 500 mg/5 mL (10 %) | Y | N | ||
| 14789012205 | FLUORESCEIN SODIUM | fluorescein sodium | VIAL | 500 mg/5 mL (10 %) | Y | N | ||
| 14789012207 | FLUORESCEIN SODIUM | fluorescein sodium | VIAL | 500 mg/5 mL (10 %) | Y | N | ||
| 00065009265 | FLUORESCITE | fluorescein sodium | VIAL | 500 mg/5 mL (10 %) | Y | N | ||
| 00407878701 | FLYRCADO | flurpiridaz F-18 | VIAL | 190 MBq/mL to 2,050 MBq/mL (5 mCi/mL to 55 mCi/mL) | Y | N | ||
| 50419032528 | GADAVIST | gadobutrol | SYRINGE | 10 mmol/10 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032529 | GADAVIST | gadobutrol | SYRINGE | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032521 | GADAVIST | gadobutrol | SYRINGE | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032527 | GADAVIST | gadobutrol | SYRINGE | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032508 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032509 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032514 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032515 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032518 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032519 | GADAVIST | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 65219028710 | GADOBUTROL | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 65219028730 | GADOBUTROL | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 65219028910 | GADOBUTROL | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 65219028965 | GADOBUTROL | gadobutrol | VIAL | 1 mmol/mL (604.72 mg/mL) | Y | N | ||
| 50419032502 | GADAVIST | gadobutrol | VIAL | 10 mmol/10 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032512 | GADAVIST | gadobutrol | VIAL | 10 mmol/10 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028108 | GADOBUTROL | gadobutrol | VIAL | 10 mmol/10 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028110 | GADOBUTROL | gadobutrol | VIAL | 10 mmol/10 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032503 | GADAVIST | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032513 | GADAVIST | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028105 | GADOBUTROL | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028115 | GADOBUTROL | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021434 | GADOBUTROL | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021454 | GADOBUTROL | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021480 | GADOBUTROL | gadobutrol | VIAL | 15 mmol/15 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032507 | GADAVIST | gadobutrol | VIAL | 2 mmol/2 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032537 | GADAVIST | gadobutrol | VIAL | 2 mmol/2 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028100 | GADOBUTROL | gadobutrol | VIAL | 2 mmol/2 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028102 | GADOBUTROL | gadobutrol | VIAL | 2 mmol/2 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032501 | GADAVIST | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 50419032511 | GADAVIST | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028103 | GADOBUTROL | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 65219028107 | GADOBUTROL | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021232 | GADOBUTROL | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021254 | GADOBUTROL | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 70436021280 | GADOBUTROL | gadobutrol | VIAL | 7.5 mmol/7.5 mL (1 mmol/mL = 604.72 mg/mL) | Y | N | ||
| 00407069022 | OMNISCAN | gadodiamide | SYRINGE | 10 mmol/20 mL (287 mg/mL) | Y | N | ||
| 00407069012 | OMNISCAN | gadodiamide | SYRINGE | 5 mmol/10 mL (287 mg/mL) | Y | N | ||
| 00407069017 | OMNISCAN | gadodiamide | SYRINGE | 7.5 mmol/15 mL (287 mg/mL) | Y | N | ||
| 00407069020 | OMNISCAN | gadodiamide | VIAL | 10 mmol/20 mL (287 mg/mL) | Y | N | ||
| 00407069005 | OMNISCAN | gadodiamide | VIAL | 2.5 mmol/5 mL (287 mg/mL) | Y | N | ||
| 00407069010 | OMNISCAN | gadodiamide | VIAL | 5 mmol/10 mL (287 mg/mL) | Y | N | ||
| 00407069015 | OMNISCAN | gadodiamide | VIAL | 7.5 mmol/15 mL (287 mg/mL) | Y | N | ||
| 00407294322 | CLARISCAN | gadoterate meglumine | SYRINGE | 10 mmol/20 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294312 | CLARISCAN | gadoterate meglumine | SYRINGE | 5 mmol/10 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294317 | CLARISCAN | gadoterate meglumine | SYRINGE | 7.5 mmol/15 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294305 | CLARISCAN | gadoterate meglumine | VIAL | 10 mmol/20 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008601 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 10 mmol/20 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008620 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 10 mmol/20 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012335 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 10 mmol/20 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294306 | CLARISCAN | gadoterate meglumine | VIAL | 2.5 mmol/5 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008001 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 2.5 mmol/5 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008005 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 2.5 mmol/5 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012331 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 2.5 mmol/5 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294301 | CLARISCAN | gadoterate meglumine | VIAL | 5 mmol/10 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008201 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 5 mmol/10 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008210 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 5 mmol/10 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012333 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 5 mmol/10 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294370 | CLARISCAN | gadoterate meglumine | VIAL | 50 mmol/100 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008806 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 50 mmol/100 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008850 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 50 mmol/100 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012340 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 50 mmol/100 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012356 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 50 mmol/100 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 00407294302 | CLARISCAN | gadoterate meglumine | VIAL | 7.5 mmol/15 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008401 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 7.5 mmol/15 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 65219008415 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 7.5 mmol/15 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012334 | GADOTERATE MEGLUMINE | gadoterate meglumine | VIAL | 7.5 mmol/15 mL (0.5 mmol/mL = 376.9 mg/mL) | Y | N | ||
| 70436012131 | GADOTERIDOL | gadoteridol | VIAL | 279.3 mg/mL | Y | N | ||
| 70436012133 | GADOTERIDOL | gadoteridol | VIAL | 279.3 mg/mL | Y | N | ||
| 70436012134 | GADOTERIDOL | gadoteridol | VIAL | 279.3 mg/mL | Y | N | ||
| 70436012135 | GADOTERIDOL | gadoteridol | VIAL | 279.3 mg/mL | Y | N | ||
| 50419032005 | EOVIST | gadoxetate disodium | VIAL | 2.5 mmol/10 mL (181.43 mg/mL) | Y | N | ||
| 50419032015 | EOVIST | gadoxetate disodium | VIAL | 3.75 mmol/15 mL (181.43 mg/mL) | Y | N | ||
| 69945018006 | GALLIUM CITRATE GA-67 | gallium-67 citrate | VIAL | 74 MBq/mL (2 mCi/mL) | Y | N | ||
| 69945018012 | GALLIUM CITRATE GA-67 | gallium-67 citrate | VIAL | 74 MBq/mL (2 mCi/mL) | Y | N | ||
| 00517290101 | GVOKE VIALDX | glucagon | VIAL | 1 mg/0.2 mL | Y | N | ||
| 00517290110 | GVOKE VIALDX | glucagon | VIAL | 1 mg/0.2 mL | Y | N | ||
| 81284031500 | BLUDIGO | indigotindisulfonate sodium | AMPUL | 8 mg/mL (0.8 %) | Y | N | ||
| 81284031505 | BLUDIGO | indigotindisulfonate sodium | AMPUL | 8 mg/mL (0.8 %) | Y | N | ||
| 69945005040 | OCTREOSCAN | indium-111 chlor/pentetreotide | KIT | 3 mCi/mL-10 mcg | Y | N | ||
| 69945013206 | INDIUM IN-111 CHLORIDE | indium-111 chloride | VIAL | 5 mCi/0.5 mL (185 MBq) | Y | N | ||
| 65219038103 | IODIXANOL | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 65219038105 | IODIXANOL | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 65219038110 | IODIXANOL | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 65219038150 | IODIXANOL | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 00407222216 | VISIPAQUE | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 00407222217 | VISIPAQUE | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 00407222219 | VISIPAQUE | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 00407222221 | VISIPAQUE | iodixanol | INFUS. BTL | 270 mg iodine/mL | Y | N | ||
| 65219038302 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038304 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038305 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038306 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038308 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038310 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038350 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 65219038370 | IODIXANOL | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222316 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222317 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222319 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222321 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222323 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222355 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222362 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222364 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222366 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 00407222367 | VISIPAQUE | iodixanol | INFUS. BTL | 320 mg iodine/mL | Y | N | ||
| 69945016605 | IOFLUPANE I-123 | ioflupane I 123 | VIAL | 5 mCi/2.5 mL (185 MBq/2.5 mL) | Y | N | ||
| 00407140152 | OMNIPAQUE | iohexol | INFUS. BTL | 140 mg iodine/mL | Y | N | ||
| 00407141227 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141228 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141230 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141233 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141234 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141235 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141238 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141282 | OMNIPAQUE | iohexol | INFUS. BTL | 240 mg iodine/mL | Y | N | ||
| 00407141348 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141353 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141355 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141356 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141359 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141361 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141362 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141363 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141365 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141366 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141368 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141369 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141372 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141386 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141387 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141388 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141389 | OMNIPAQUE | iohexol | INFUS. BTL | 300 mg iodine/mL | Y | N | ||
| 00407141448 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141472 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141476 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141482 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141483 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141484 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141486 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141487 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141488 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141489 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141490 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141491 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141493 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141494 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141495 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141498 | OMNIPAQUE | iohexol | INFUS. BTL | 350 mg iodine/mL | Y | N | ||
| 00407141270 | OMNIPAQUE | iohexol | PLAST. BAG | 240 mg iodine/mL | Y | N | ||
| 00407141275 | OMNIPAQUE | iohexol | PLAST. BAG | 240 mg iodine/mL | Y | N | ||
| 00407141285 | OMNIPAQUE | iohexol | PLAST. BAG | 240 mg iodine/mL | Y | N | ||
| 00407141286 | OMNIPAQUE | iohexol | PLAST. BAG | 240 mg iodine/mL | Y | N | ||
| 00407141344 | OMNIPAQUE | iohexol | PLAST. BAG | 300 mg iodine/mL | Y | N | ||
| 00407141380 | OMNIPAQUE | iohexol | PLAST. BAG | 300 mg iodine/mL | Y | N | ||
| 00407141612 | OMNIPAQUE | iohexol | SOLUTION | 12 mg iodine/mL | Y | N | ||
| 00407141509 | OMNIPAQUE | iohexol | SOLUTION | 9 mg iodine/mL | Y | N | ||
| 00407141110 | OMNIPAQUE | iohexol | VIAL | 180 mg iodine/mL | Y | N | ||
| 00407141120 | OMNIPAQUE | iohexol | VIAL | 180 mg iodine/mL | Y | N | ||
| 00407141210 | OMNIPAQUE | iohexol | VIAL | 240 mg iodine/mL | Y | N | ||
| 00407141220 | OMNIPAQUE | iohexol | VIAL | 240 mg iodine/mL | Y | N | ||
| 00407141283 | OMNIPAQUE | iohexol | VIAL | 240 mg iodine/mL | Y | N | ||
| 00407141310 | OMNIPAQUE | iohexol | VIAL | 300 mg iodine/mL | Y | N | ||
| 00407141340 | OMNIPAQUE | iohexol | VIAL | 300 mg iodine/mL | Y | N | ||
| 00074753123 | IOPAMIDOL | iopamidol | INFUS. BTL | 300 mg iodine/mL (61 %) | Y | N | ||
| 00074753124 | IOPAMIDOL | iopamidol | INFUS. BTL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436012433 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436012435 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436012452 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436012482 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436021137 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436021180 | IOPAMIDOL | iopamidol | VIAL | 200 mg iodine/mL (41 %) | Y | N | ||
| 70436012537 | IOPAMIDOL | iopamidol | VIAL | 250 mg iodine/mL (51 %) | Y | N | ||
| 70436012582 | IOPAMIDOL | iopamidol | VIAL | 250 mg iodine/mL (51 %) | Y | N | ||
| 70436012634 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436012682 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021936 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021937 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021940 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021952 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021962 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436021982 | IOPAMIDOL | iopamidol | VIAL | 300 mg iodine/mL (61 %) | Y | N | ||
| 70436012740 | IOPAMIDOL | iopamidol | VIAL | 370 mg iodine/mL (76 %) | Y | N | ||
| 70436012782 | IOPAMIDOL | iopamidol | VIAL | 370 mg iodine/mL (76 %) | Y | N | ||
| 50419034215 | ULTRAVIST | iopromide | VIAL | 240 mg iodine/mL | Y | N | ||
| 50419034220 | ULTRAVIST | iopromide | VIAL | 240 mg iodine/mL | Y | N | ||
| 50419034405 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034410 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034412 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034415 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034421 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034422 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034423 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034450 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034458 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034461 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034464 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034465 | ULTRAVIST | iopromide | VIAL | 300 mg iodine/mL | Y | N | ||
| 50419034605 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034610 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034615 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034620 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034625 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034627 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034628 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034633 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034650 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034658 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034660 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034665 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034813 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 50419034820 | ULTRAVIST | iopromide | VIAL | 370 mg iodine/mL | Y | N | ||
| 67457022000 | ISOSULFAN BLUE | isosulfan blue | VIAL | 1 % (10 mg/mL) | Y | N | ||
| 67457022005 | ISOSULFAN BLUE | isosulfan blue | VIAL | 1 % (10 mg/mL) | Y | N | ||
| 67457058600 | ISOSULFAN BLUE | isosulfan blue | VIAL | 1 % (10 mg/mL) | Y | N | ||
| 67457058605 | ISOSULFAN BLUE | isosulfan blue | VIAL | 1 % (10 mg/mL) | Y | N | ||
| 69488000140 | NETSPOT | kit for prep of Ga 68/dotatate | VIAL | 40 mcg | Y | N | ||
| 69945013910 | PULMOTECH MAA | kit for prep of Tc-99m/albumin | VIAL | 2 mg | Y | N | ||
| 69945013920 | PULMOTECH MAA | kit for prep of Tc-99m/albumin | VIAL | 2 mg | Y | N | ||
| 69945013940 | PULMOTECH MAA | kit for prep of Tc-99m/albumin | VIAL | 2 mg | Y | N | ||
| 11994000100 | CARDIOLITE | kit for Tc 99m/sestamibi no.1 | SYRINGE | Y | N | |||
| 11994000120 | CARDIOLITE | kit for Tc 99m/sestamibi no.1 | VIAL | Y | N | |||
| 11994000155 | CARDIOLITE | kit for Tc 99m/sestamibi no.1 | VIAL | Y | N | |||
| 11994000320 | TC99M SESTAMIBI PREP | kit for Tc 99m/sestamibi no.1 | VIAL | Y | N | |||
| 69945009220 | TC99M SESTAMIBI PREP | kit for Tc 99m/sestamibi no.1 | VIAL | Y | N | |||
| 69945009240 | TC99M SESTAMIBI PREP | kit for Tc 99m/sestamibi no.1 | VIAL | Y | N | |||
| 69945006820 | ULTRATAG RBC | kit for Tc-99m-labeled RBCs | VIAL | Y | N | |||
| 11994000602 | NEUROLITE | kit for Tc-99m/bicisate di-HCl | VIAL | 0.9 mg | Y | N | ||
| 11994000605 | NEUROLITE | kit for Tc-99m/bicisate di-HCl | VIAL | 0.9 mg | Y | N | ||
| 69945009120 | TECHNESCAN HDP | kit for Tc-99m/sod oxidronate | VIAL | 3.15 mg | Y | N | ||
| 69945009140 | TECHNESCAN HDP | kit for Tc-99m/sod oxidronate | VIAL | 3.15 mg | Y | N | ||
| 69945009420 | TECHNESCAN PYP | kit for Tc-99m/sod pyrophospht | VIAL | 11.9 mg | Y | N | ||
| 74725010025 | ILLUCCIX | kit prep of Ga-68/gozetotide | VIAL | 25 mcg | Y | N | ||
| 74725010064 | ILLUCCIX | kit prep of Ga-68/gozetotide | VIAL | 25 mcg | Y | N | ||
| 69488001761 | LOCAMETZ | kit prep of Ga-68/gozetotide | VIAL | 25 mcg | Y | N | ||
| 69945031401 | TC99M PENTETATE PREP | kit prep Tc 99m/pentetic acid | VIAL | 20 mg | Y | N | ||
| 69945031405 | TC99M PENTETATE PREP | kit prep Tc 99m/pentetic acid | VIAL | 20 mg | Y | N | ||
| 69945031430 | TC99M PENTETATE PREP | kit prep Tc 99m/pentetic acid | VIAL | 20 mg | Y | N | ||
| 69945009620 | TECHNESCAN MAG3 | kit Tc-99m/mertiatide (betiat) | VIAL | 1 mg | Y | N | ||
| 82292004001 | LUMISIGHT | pegulicianine acetate | VIAL | 39 mg | Y | N | ||
| 82292004010 | LUMISIGHT | pegulicianine acetate | VIAL | 39 mg | Y | N | ||
| 11994001101 | DEFINITY | perflutren lipid microspheres | VIAL | 1.1 mg/mL | Y | N | ||
| 11994001104 | DEFINITY | perflutren lipid microspheres | VIAL | 1.1 mg/mL | Y | N | ||
| 11994001116 | DEFINITY | perflutren lipid microspheres | VIAL | 1.1 mg/mL | Y | N | ||
| 00407270703 | OPTISON | perflutren protein-A microsphr | VIAL | 0.22 mg (+/- 0.11) mg/mL | Y | N | ||
| 00407270718 | OPTISON | perflutren protein-A microsphr | VIAL | 0.22 mg (+/- 0.11) mg/mL | Y | N | ||
| 71258002200 | PYLARIFY | piflufolastat F 18 | SYRINGE | 296 MBq to 370 MBq (8 mCi to 10 mCi) | Y | N | ||
| 71258002201 | PYLARIFY | piflufolastat F 18 | VIAL | 37 MBq/mL to 2,960 MBq/mL (1 mCi/mL to 80 mCi/mL) | Y | N | ||
| 00469650189 | LEXISCAN | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 00409140101 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 00409140105 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 00641625301 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 16729047731 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 36000036401 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 55150044301 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 60505611600 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 60505628800 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 67457099405 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 71288020185 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 76329332100 | REGADENOSON | regadenoson | SYRINGE | 0.4 mg/5 mL | Y | N | ||
| 72611087401 | REGADENOSON | regadenoson | VIAL | 0.4 mg/5 mL | Y | N | ||
| 72611087410 | REGADENOSON | regadenoson | VIAL | 0.4 mg/5 mL | Y | N | ||
| 69945060110 | SODIUM IODIDE I-123 | sodium iodide-123 | CAPSULE | 3.7 MBq (100 microCi) | Y | N | ||
| 69945060220 | SODIUM IODIDE I-123 | sodium iodide-123 | CAPSULE | 7.4 MBq (200 microCi) | Y | N | ||
| 11994009101 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009103 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009104 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009105 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009106 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009107 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009109 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009110 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009111 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009112 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009136 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009173 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 11994009192 | TECHNELITE TC-99M GENERATOR | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945001003 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945001504 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945002005 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945002506 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945003007 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945003508 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945005109 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945006010 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945007511 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945011012 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945014013 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945016014 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945019015 | ULTRA-TECHNEKOW V4 | sodium pertechnetate Tc-99m | VIAL | Y | N | |||
| 69945012028 | THALLOUS CHLORIDE TL-201 | thallous chloride Tl-201 | VIAL | 37 MBq/mL (1 mCi/mL) | Y | N | ||
| 69945012056 | THALLOUS CHLORIDE TL-201 | thallous chloride Tl-201 | VIAL | 37 MBq/mL (1 mCi/mL) | Y | N | ||
| 69945012063 | THALLOUS CHLORIDE TL-201 | thallous chloride Tl-201 | VIAL | 37 MBq/mL (1 mCi/mL) | Y | N | ||
| 69945012099 | THALLOUS CHLORIDE TL-201 | thallous chloride Tl-201 | VIAL | 37 MBq/mL (1 mCi/mL) | Y | N | ||
| 10370041494 | REVEAL UTI TEST STRIP | urinary tract infection test | STICK (EA) | Y | N | |||
| 69945009711 | XENON XE-133 | xenon 133 in air | GAS (EA) | 370 MBq (10 mCi) | Y | N | ||
| 69945009713 | XENON XE-133 | xenon 133 in air | GAS (EA) | 370 MBq (10 mCi) | Y | N | ||
| 69945009715 | XENON XE-133 | xenon 133 in air | GAS (EA) | 370 MBq (10 mCi) | Y | N | ||
| 69945009821 | XENON XE-133 | xenon 133 in air | GAS (EA) | 740 MBq (20 mCi) | Y | N | ||
| 69945009823 | XENON XE-133 | xenon 133 in air | GAS (EA) | 740 MBq (20 mCi) | Y | N | ||
| 69945009825 | XENON XE-133 | xenon 133 in air | GAS (EA) | 740 MBq (20 mCi) | Y | N | ||
| 11994012711 | XENON XE-133 | xenon 133 in carbon dioxide | GAS (EA) | 370 MBq (10 mCi) | Y | N | ||
| 11994012715 | XENON XE-133 | xenon 133 in carbon dioxide | GAS (EA) | 370 MBq (10 mCi) | Y | N | ||
| 11994012821 | XENON XE-133 | xenon 133 in carbon dioxide | GAS (EA) | 740 MBq (20 mCi) | Y | N | ||
| 11994012825 | XENON XE-133 | xenon 133 in carbon dioxide | GAS (EA) | 740 MBq (20 mCi) | Y | N |