Diabetic Supplies

Showing all 11 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
Alcohol Swabs Pads 70% (Generic)	No Brand Option Available	Diabetic Supplies	1	Generic	$14
Bd Insulin Syringe Misc 29G X 1/2″ 1 Ml (Brand)	Insulin Syringe/Needle U-100 Misc (Generic)	Diabetic Supplies	2	Formulary Brand	$38
Bd Insulin Syringe U/F Misc 30G X 1/2″ 0.5 Ml (Brand)	Insulin Syringe/Needle U-100 Misc (Generic)	Diabetic Supplies	2	Formulary Brand	$38
Bd Insulin Syringe U/F Misc 31G X 5/16″ 0.3 Ml (Brand)	Insulin Syringe/Needle U-100 Misc (Generic)	Diabetic Supplies	2	Formulary Brand	$38
Bd Insulin Syringe U/F Misc 31G X 5/16″ 1 Ml (Brand)	Insulin Syringe/Needle U-100 Misc (Generic)	Diabetic Supplies	2	Formulary Brand	$38
Bd Pen Needle Original U/F Misc 29G X 12.7Mm (Brand)	Insulin Pen Needle Misc (Generic)	Diabetic Supplies	3	Non-Formulary Brand	$68
Curity Gauze Pads 2″X2″ (Brand)	Gauze Pads & Dressings Pads (Generic)	Diabetic Supplies	3	Non-Formulary Brand	$68
Gauze Pads & Dressings Pads (Generic)	Curity Gauze Pads 2"X2" (Brand)	Diabetic Supplies	1	Generic	$14
Omnipod 5 G6 POD (Brand)	Insulin Infusion Disposable Pump (Generic)	Diabetic Supplies	3	Non-Formulary Brand	$68
Omnipod 5 G6 Starter Kit (Brand)	Insulin Infusion Disposable Pump Kit (Generic)	Diabetic Supplies	3	Non-Formulary Brand	$68
Omnipod Starter Kit (Brand)	Insulin Infusion Disposable Pump Kit (Generic)	Diabetic Supplies	3	Non-Formulary Brand	$68