Interactive Drug Benefit List
DIN/NPN/ PIN Generic Name Product Name, Strength & Dosage Form Unit Price, Unit of Issue Manufacturer LCA Price MAC Price Interchangeable Products Coverage Status
00999699 GLUCOSE MONITORING RECEIVER DEXCOM G7 RECEIVER 60.0000
MIS
COM N/A N/A NO RESTRICTED BENEFIT Details
00999709 GLUCOSE MONITORING SENSOR DEXCOM G6 SENSOR 99.6700
MIS
COM N/A N/A NO RESTRICTED BENEFIT Details
00999700 GLUCOSE MONITORING SENSOR DEXCOM G7 SENSOR 75.0000
MIS
COM N/A N/A NO RESTRICTED BENEFIT Details
00999708 GLUCOSE MONITORING TRANSMITTER DEXCOM G6 TRANSMITTER 29.0000
MIS
COM N/A N/A NO RESTRICTED BENEFIT Details
DIN/NPN/ PIN 00999699
Generic Name GLUCOSE MONITORING RECEIVER
Product Name, Strength & Dosage Form DEXCOM G7 RECEIVER
Unit Price, Unit of Issue 60.0000
Manufacturer COM
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 00999709
Generic Name GLUCOSE MONITORING SENSOR
Product Name, Strength & Dosage Form DEXCOM G6 SENSOR
Unit Price, Unit of Issue 99.6700
Manufacturer COM
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 00999700
Generic Name GLUCOSE MONITORING SENSOR
Product Name, Strength & Dosage Form DEXCOM G7 SENSOR
Unit Price, Unit of Issue 75.0000
Manufacturer COM
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status RESTRICTED BENEFIT
Details
DIN/NPN/ PIN 00999708
Generic Name GLUCOSE MONITORING TRANSMITTER
Product Name, Strength & Dosage Form DEXCOM G6 TRANSMITTER
Unit Price, Unit of Issue 29.0000
Manufacturer COM
LCA Price N/A
MAC Price N/A
Interchangeable Products NO
Coverage Status RESTRICTED BENEFIT
Details
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NOTICE:
The DBL, DBS and related publications require knowledgeable interpretation and are intended primarily for professional health care practitioners, pharmacies, hospitals and organizations associated with the manufacture, distribution and use of pharmaceutical preparations.
Electronic versions of all DBL and DBS related publications are unofficial versions and are provided for convenience and private use only. Official paper versions can be obtained from Alberta Blue Cross who publishes them on behalf of Alberta Health and Alberta Human Services.
Alberta Health reserves the right to make changes, without notice, to the List through the Interactive DBL(iDBL), and any such changes to the Interactive DBL(iDBL) are effective the date of the change (unless otherwise stated) and regardless of the date of publication in the paper version or updates.