Вы находитесь на странице: 1из 3

Last Updated: July 3, 2014

PharmaCare Insulin Pump Supplies


Product Names, Identification Numbers (PINs) and Descriptions
The table below lists the insulin pump supplies that are eligible for coverage. Actual coverage is subject to the usual rules
of the patient's PharmaCare plan.
The most recent updates are indicated in red.

Questions? Please contact Health Insurance BC.

Insulin Pump Supplies - Reservoirs/Cartridges


Product Name PIN Product Description
Auto Control Medical (ACM)
ACM Cozmo 3 ml IP Cartridge 47450001 Insulin cartridges for Cozmo insulin pumps.
ACM Thinset 1.8 or 3 ml IP Reservoir 47450002 Insulin reservoirs for Paradigm insulin pumps.
ACM Thinset 3 ml IP Syringe Reservoir 47450003 Insulin reservoirs for Minimed insulin pumps.
Animas Canada
Animas 2 or 3 ml IP Cartridge 47450004 Insulin cartridges for Animas OneTouch Ping, 2020,
IR1200 and IR1000 insulin pumps.
Disetronic Medical Systems Inc. (DMSI)
DMSI Accu-Chek Spirit 3.15 ml IP Cartridge 47450005 Insulin cartridges for Accu-Chek insulin pump
systems.
Medtronic
Medtronic Minimed 3 cc IP Syringe Reservoir 47450006 Insulin reservoirs for Minimed 500/400 series insulin
pumps.
Medtronic Paradigm 1.76 or 3 ml IP Cartridge 47450007 Insulin reservoirs for Paradigm 522 and 722 insulin
pumps.

Insulin Pump Supplies – Infusion Sets/Kits


Product Name PIN Product Description
Auto Control Medical (ACM)
ACM Cleo 90 Infusion Set 46340001 Cleo 90 (6 mm and 9 mm) infusion sets (10
cannulas/10 tubing).
ACM Comfort Cannulas Only 46340002 Comfort (17 mm) and Comfort Short (13 mm)
cannulas only, no tubing.
ACM Comfort Infusion Set or Combo or 46340003 Comfort (17 mm) and Comfort Short (13 mm)
ShortCombo infusion sets (10 cannulas/10 tubing).
ACM Contact Detach Infusion Set 46340004 Contact Detach (6 mm and 8 mm) infusion sets. (10
cannulas/10 tubing)
Product Name PIN Product Description
ACM Thalaset Infusion Set 46340005 Thalaset (6 mm, 8 mm and 10 mm) infusion sets.
Neria-Thalaset (6 mm, 8 mm and 10 mm) infusion
sets (10 cannulas/10 tubing).
ACM Thinset Infusion Set 46340006 Thinset (6 mm and 9 mm) infusion sets.
Animas Canada
Animas Comfort Infusion Set or Combo 46340007 Comfort (17 mm) and Comfort Short (13 mm)
infusion sets (10 cannulas/10 tubing).
Comfort Combo (17 mm) and Comfort Short Combo
(13 mm) infusion sets (10 cannulas/5 tubing).
Animas Contact Detach Infusion Set 46340008 Contact Detach (6 mm and 8 mm) infusion sets.
Animas Inset II or 30 Infusion Set 46340009 Inset II (6 mm and 9 mm) and Inset 30 (13 mm)
infusion sets.
Disetronic Medical Systems Inc. (DMSI)
DMSI Accuchek Rapid-D Infusion Set 46340010 Rapid-D (6 mm, 8 mm and 10 mm) infusion sets.
DMSI Accuchek Tender 1 or 2 Infusion Set 46340011 Tender-1 (17 mm) and Tender-1 Mini (13 mm)
infusion sets (10 cannulas/10 tubing).
Tender-2 (17 mm) and Tender-2 Mini (13 mm)
infusion sets (20 cannulas/10 tubing).
DMSI Accuchek Ultraflex 1 or 2 Infusion Set 46340012 Ultraflex-1 (8 mm and 10 mm) infusion sets
(10 cannulas/10 tubing).
Ultraflex-2 (8 mm and 10 mm) infusion sets
(20 cannulas/10 tubing).
Insulet Canada Corporation

OmniPod – Pod ZXR425 46340028 Disposable integrated insulin infusion inserter and
reservoir (“the Pod”)
Medtronic

Medtronic Paradigm Polyfin QR Infusion Set 46340013 Paradigm Polyfin QR bent needle infusion sets (24"
and 42").
Medtronic Paradigm Quick-Set Infusion Set 46340014 Paradigm Quick-Set (6 mm and 9 mm) infusion sets.
Medtronic Paradigm Silhouette Infusion 46340015 Paradigm Silhouette (13 mm and 17 mm) infusion
Set/Combo sets (10 cannulas/10 tubing)
Medtronic Paradigm Sof-Set QR Infusion Set 46340016 Paradigm Sof-Set Ultimate QR (9 mm) and Micro QR
(6 mm) infusion sets.
Medtronic Paradigm Sure-T Infusion Set 46340017 Paradigm Sure-T straight needle infusion sets.
Medtronic Minimed Polyfin or Polyfin QR 46340018 Minimed 500/400 Series Polyfin EXT, Polyfin (42")
Infusion Set Bent Needle, Polyfin (24" and 42") Bent Needle w/
Wings, Polyfin QR (42") Bent Needle, Polyfin QR
(24" and 42") Bent Needle w/Wings infusion sets
Medtronic Minimed Quick-Set Infusion Set 46340019 Minimed 500/400 Series Quick-Set (6 mm and 9 mm)
infusion sets (10 cannulas/10 tubing).
Product Name PIN Product Description
Medtronic Minimed Silhouette Infusion Set or 46340020 Minimed 500/400 Series Silhouette Full Set (23" and
Combo 43") infusion sets (10 cannulas/10 tubing).
Minimed 500/400 Series Silhouette Combo Set
(23" and 43") infusion sets (10 cannulas/5 tubing)
Medtronic Minimed Sof-Set or Sof-Set QR 46340021 Minimed 500/400 Series Sof-Set Ultimate QR (9 mm)
Infusion Set and Micro QR (6 mm) infusion sets (12 cannulas/
12 tubing).
Minimed 500/400 Series Sof-Set (24" and 42")
(24 cannulas/24 tubing)
Medtronic Silhouette Cannula Only Infusion 46340022 Medtronic Paradigm (13mm & 17mm) infusion sets,
Set cannula only (10 cannulas with no tubing)
Medtronic Paradigm mio™ Infusion set 46340023 Medtronic Paradigm mio™ (6mm & 9mm) infusion
sets (10 cannulas/10 tubing)
Ypsomed AG
Orbit 90 SC Infusion Set 46340026 Orbit 90 Teflon Infusion Sets (6 mm and 9 mm)
infusion sets (10 cannulas/10 tubing)
Orbit Micro SC SC Infusion Set 46340027 Orbit Micro Steel Infusion Sets (5.5 mm and
8.5 mm) infusion sets (10 cannulas/10 tubing)

Вам также может понравиться