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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 />
57599004305 ABBOTT DIABETES MEDISENSE THIN LANCETS<br />
57599006305 ABBOTT DIABETES PRECISION PCX PLUS TEST STR<br />
57599011605 ABBOTT DIABETES PRECISION POINT OF CARE STR<br />
57599013801 ABBOTT DIABETES MEDISENSE GLUC-KET CONT SOL<br />
57599013901 ABBOTT DIABETES MEDISENSE GLUC-KET CONT SOL<br />
57599031201 ABBOTT DIABETES MEDISENSE GLUC-KET CONT SOL<br />
57599033901 ABBOTT DIABETES PRECISION PCX PLUS TEST STR<br />
57599055001 ABBOTT DIABETES MEDISENSE H-L CONTROL SOLUTION<br />
57599055101 ABBOTT DIABETES MEDISENSE H-M-L CONTROL SOLN<br />
57599055201 ABBOTT DIABETES MEDISENSE MID CONTROL SOLUTION<br />
57599104104 ABBOTT DIABETES OPTIUM EZ TEST STRIP<br />
57599104205 ABBOTT DIABETES OPTIUM EZ TEST STRIP<br />
57599471102 ABBOTT DIABETES PRECISION CONTROL SOLUTION<br />
57599713701 ABBOTT DIABETES ULTRATLC LANCETS<br />
57599713805 ABBOTT DIABETES ULTRATLC LANCETS<br />
57599740004 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599740105 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599741102 ABBOTT DIABETES PRECISION CONTROL SOLUTION<br />
57599743201 ABBOTT DIABETES MEDISENSE CONTROL SOLUTION<br />
57599813803 ABBOTT DIABETES ULTRATLC THIN LANCETS<br />
57599822801 ABBOTT DIABETES PRECISION Q-I-D PEN<br />
57599833501 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599833601 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599841101 ABBOTT DIABETES PRECISION CONTROL SOLUTION<br />
57599843601 ABBOTT DIABETES PRECISION CONTROL SOLUTION<br />
57599854601 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599854701 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599854801 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599854901 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599855001 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599857301 ABBOTT DIABETES PRECISION COLORED METER<br />
57599857401 ABBOTT DIABETES PRECISION COLORED METER<br />
57599857501 ABBOTT DIABETES PRECISION COLORED METER<br />
57599857601 ABBOTT DIABETES PRECISION COLORED METER<br />
57599868102 ABBOTT DIABETES MEDISENSE THIN LANCETS<br />
57599868105 ABBOTT DIABETES MEDISENSE THIN LANCETS<br />
57599868205 ABBOTT DIABETES MEDISENSE THIN LANCETS<br />
57599868206 ABBOTT DIABETES MEDISENSE THIN LANCETS<br />
57599872901 ABBOTT DIABETES EXACTECH TEST STRIPS<br />
57599873001 ABBOTT DIABETES EXACTECH TEST STRIPS<br />
57599873201 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599873204 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599873301 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599873305 ABBOTT DIABETES PRECISION Q-I-D TEST STRIPS<br />
57599874605 ABBOTT DIABETES UNISTIK 2 NORMAL 0.81MM DEVICE<br />
57599874605 ABBOTT DIABETES UNISTIK 2 NORMAL 0.81MM DEVICE<br />
57599874705 ABBOTT DIABETES UNISTIK 2 EXTRA 0.81 MM DEVICE<br />
57599874705 ABBOTT DIABETES UNISTIK 2 EXTRA 0.81 MM DEVICE<br />
57599875705 ABBOTT DIABETES PRECISION PCX TEST STRIPS<br />
57599881401 ABBOTT DIABETES PRECISION XTRA MONITOR<br />
57599889401 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
57599889501 ABBOTT DIABETES PRECISION SURE DOSE SYRINGE<br />
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