You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Oregon Health Authority<br />
Division of Medical Assistance Programs<br />
Allowable NDCs <strong>for</strong> Diabetic Supply Billing - Effective 8/1/2011<br />
For <strong>billing</strong> guidelines and examples:<br />
Refer to OAR 410-122-0520 (Glucose Monitors and Diabetic Supplies) and the Diabetic Supply<br />
Billing Examples at www.dhs.state.or.us/policy/healthplan/guides/dme/main.html.<br />
NDC Code Labeler Name Label Name Desc<br />
32671000501 MEDICORE LITE TOUCH INSULIN 1 ML SYR<br />
32671000502 MEDICORE LITE TOUCH INSULIN 0.5 ML SYR<br />
32671000503 MEDICORE LITE TOUCH INSULIN 1 ML SYR<br />
32671000504 MEDICORE LITE TOUCH INSULIN 0.5 ML SYR<br />
32671000505 MEDICORE LITE TOUCH INSULIN 1 ML SYR<br />
32671000506 MEDICORE LITE TOUCH INSULIN 0.3 ML SYR<br />
32671000507 MEDICORE LITE TOUCH INSULIN 0.3 ML SYR<br />
32671000508 MEDICORE LITE TOUCH INSULIN SYR 0.3 ML<br />
32671000509 MEDICORE LITE TOUCH INSULIN SYR 0.5 ML<br />
32671000514 MEDICORE LITE TOUCH INSULIN 0.5 ML SYR<br />
32671000520 MEDICORE LITE TOUCH INSULIN SYR 1 ML<br />
32671020044 MEDICORE AURORA HEALTH LANCET DEVICE<br />
32671020100 MEDICORE MEDI-LANCE LANCETS<br />
32671020133 MEDICORE LITE TOUCH LANCETS<br />
32671020144 MEDICORE AURORA HEALTHCARE LANCETS<br />
32671020200 MEDICORE MEDI-LANCE LANCETS<br />
32671020233 MEDICORE LITE TOUCH LANCETS<br />
32671020244 MEDICORE AURORA HEALTHCARE LANCETS<br />
35515095934 CHAIN DRUG QC ADVANCED LANCING DEVICE<br />
35515095934 CHAIN DRUG QC ADVANCED LANCING DEVICE<br />
35515095935 CHAIN DRUG QC SUPER THIN LANCET<br />
35515095936 CHAIN DRUG QC ULTRA THIN LANCET<br />
37205608104 LEADER INSULIN 1 ML SYRINGE<br />
37205608204 LEADER INSULIN 1/2 ML SYRINGE<br />
37205608304 LEADER INSULIN 3/10 ML SYRINGE<br />
37654049726 SACKS MEDICAL REFUAH PLUS MONITORING SYSTEM<br />
37654049727 SACKS MEDICAL REFUAH PLUS TEST STRIPS<br />
37654049728 SACKS MEDICAL REFUAH PLUS CONTROL SOLUTION<br />
37867099246 CAN-AM/ACCESS MONOJECT SYRINGE 0.3 ML<br />
37867099247 CAN-AM/ACCESS MONOJECT SYRINGE 0.5 ML<br />
37867099248 CAN-AM/ACCESS MONOJECT SYRINGE 1 ML<br />
38396000010 CAN-AM/ACCESS W&F COLORED LANCETS<br />
38396000425 CAN-AM/ACCESS VALUE PLUS LANCING DEVICE<br />
38396000506 CAN-AM/ACCESS KINRAY SYRING 0.3 ML 31GX5/16"<br />
38396000606 CAN-AM/ACCESS KINRAY SYRING 0.5 ML 31GX5/16"<br />
38396000706 CAN-AM/ACCESS KINRAY INS SYR 1 ML 31GX5/16"<br />
38396001078 CAN-AM/ACCESS W&F COLORED LANCETS<br />
38396016201 CAN-AM/ACCESS W&F COLORED LANCETS<br />
38396030100 CAN-AM/ACCESS E-ZJECT THIN LANCETS<br />
38396030108 CAN-AM/ACCESS LEADER THIN LANCETS<br />
38396030112 CAN-AM/ACCESS MS THIN LANCETS<br />
38396030113 CAN-AM/ACCESS FIRST CHOICE THIN LANCETS<br />
38396030114 CAN-AM/ACCESS RA E-ZJECT LANCETS<br />
38396030118 CAN-AM/ACCESS KROGER THIN LANCETS<br />
38396030120 CAN-AM/ACCESS MEIJER THIN GAUGE LANCETS<br />
38396030137 CAN-AM/ACCESS TOPCARE UNIVERSAL1 THIN LANCET<br />
38396030140 CAN-AM/ACCESS EQL LANCETS THIN<br />
38396030157 CAN-AM/ACCESS DRUG MART THIN LANCETS<br />
38396030200 CAN-AM/ACCESS E-ZJECT THIN LANCETS<br />
38396030208 CAN-AM/ACCESS LEADER THIN LANCETS<br />
38396030213 CAN-AM/ACCESS FIRST CHOICE THIN LANCETS<br />
38396030218 CAN-AM/ACCESS KROGER THIN LANCETS<br />
Page 22 of 48
Change language