PIN List. Product Name
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1 PIN List ABDOMINAL PAD ACCU-CHEK MULTICLIX LANCETS ADHESIVE TAPE AEROCHAMBER AEROCHAMBER WITH MASK ADULT AEROCHAMBER WITH MASK CHILD AMES LANCETS AMES SURELITE LANCETS AMG MEDPRO NEBULIZER ANKLE BRACE FUT ANKLE SUPPORT ANTI-STATIC COMPACT SPACE CHAMBER PLUS - MOUTHPIECE ANTI-STATIC COMPACT SPACE CHAMBER PLUS - SMALL ANTI-STATIC COMPACT SPACE CHAMBER PLUS - MEDIUM ANTI-STATIC COMPACT SPACE CHAMBER PLUS - LARGE ASTRA NEBULIZER ATHLETIC SUPPORT ATTENDS BRIEFS LGE ATTENDS BRIEFS LGE (96) ATTENDS BRIEFS MED (22) ATTENDS BRIEFS MED (96) ATTENDS BRIEFS SM (26) ATTENDS GUARDS SUP ABS (28) ATTENDS PULL-ONS XXL (12) ATTENDS UNDERGARM XAB ATTENDS UNDERGARMENT - BLTD AUTOLET LANCETS BAYER LANCETS BD DISP INSULIN SYRINGE ULTRA 1 CC BD DISP INSULIN SYRINGE ULTRA 1/2 CC BD DISP INSULIN SYRINGE ULTRA 3/10 CC BD DISP SYRINGE 25 X 5/ BD DISP NEEDLE 27 X 1/ BD INSULIN SYRINGE U/F 11 SHORT 3/10CC BD INSULIN SYRINGE U/F II SHORT 1/2CC BD INSULIN SYRINGE U/F II SHORT 1CC BD INSULIN SYRINGE WITH BD ULTRAFINE (SYRINGE/NEEDLE) BD LANCET DEVICE BD LATITUDE BD MICROFINE SYR 1 CC BD PEN NEEDLE 30G 1/ BD PEN NEEDLE U/F MINI 31G 1 of 7
2 BD PEN NEEDLE ULTRA 29G 1/ BD INSULIN SYRINGE 1/2 CC BD INSULIN SYRINGE 1/3 CC BD SYRINGE 10CC BD SYRINGE DISP 3CC BD SYRINGE DISP 5CC BD TUBERCULIN SYRINGE 1CC BD TUBERCULIN SYRINGE 1CC BD ULTRA FINE BD ULTRA FINE III PEN NEEDLE 31G BD ULTRAFINE II LANCET BD ULTRAFINE LANCET BG STAR LANCET BREAST PUMP (SPRING EXPRESS) CANE ALUMINUM PLAIN CANE ICE TIP CANE TIP CATHETERS CERVICAL COLLAR (SOFT) CLICKFINE INSULIN PEN NEEDLE (31G) CLICKFINE INSULIN PEN NEEDLE (32G) COMPOUNDED PR. ELIGIBLE COMPOUNDED PR. NOT ELIGIBLE (FOR DRUG UTILIZATION ONLY) CONDOMS CRUTCH ALUMINUM CRUTCH TIPS (PAIR) CRUTCH WOOD CURAD TELFA PAD 2X CURAD TELFA PAD 3X DARIO LANCETS DEPEND FITTED BRIEF BULK MD (88) DEPEND FITTED BRIEF LGE (18) DEPEND FITTED BRIEF MED (22) DEPEND PANTS SM (20) DEPEND POISE PADS RG (80) DEPEND POISE PADS ULT PLUS(42) DEPEND POISE PADS XTR ABS (20) DEPEND POISE PADS XTR ABS (72) DEPEND POISE PADS XTR PLUS(16) DEPEND POISE PROT SUP (30) DEPEND POISE PROT SUP PLUS ( DEPEND SHIELD XAB (14) 2 of 7
3 DEPEND UNDERGARMENT RG (12) DEPEND UNDERGARMENT RG (36) DEPEND UNDERGARMENT XAB (10) DEPEND UNDERGARMENT XAB (30) DEPEND UNDERGARMENT XAB ESY (10) DEPEND UNDERGARMENT XAB ESY (28) DEPEND UNDERGARMENT XAB ESY (30) DEPENDS FITTED BRIEF DEPENDS POISE PADS DISPOSABLE GLOVE DRESSING STRIP DROPLET PEN NEEDLE 29G DROPLET PEN NEEDLE 31G DROPLET PEN NEEDLE 32G DROPLET PERSONAL LANCET DUODERM DRESSING 4X DUODERM HYDROACTIVE GEL ELASTIC BANDAGE 3'' ELASTIC BANDAGE 4'' ELASTIC BANDAGE 6 INCH ELBOW BRACE EYE PADS EYESTIL DROPS EZ HEALTH STERILE LANCET GAUZE 2 INCH GAUZE 3 INCH GAUZE 4 INCH GAUZE PADS 2X GAUZE PADS 3X GAUZE PADS 4X HUGGIES GOODNIGHT JB LG HUGGIES GOODNIGHT JB XL HUGGIES GOODNITE MED HUGGIES PULL UPS MED HUGGIES PULL UPS SM HUGGIES PULLUP BOY JB LG HUGGIES PULLUP BOY JB XL HUGGIES PULLUP GIRL JB LG HUGGIES PULLUP GIRL JB XL INSPIRACHAMBER MOUTHPIECE INSPIRACHAMBER - SMALL INSPIRACHAMBER - MEDIUM INFUSION CASETTE (ANY BRAND) 3 of 7
4 INFUSION SET (ANY BRAND) INFUSION SET 3M INSULIN GLASS CARTRIGE INSULIN SYRINGE 3CC (ANY BRAND) INSUPEN 29G NEEDLE INSUPEN 30G NEEDLE INSUPEN 31G NEEDLE INSUPEN 32G NEEDLE INTAL SPINHALER JELONET GAUZE 10X10CM # KETO-DIASTIX KETOSTIX KLING FLEX BANDAGE KNEE BRACE #34 (FUT) KNEE BRACE #44 (FUT) KNEE BRACE FUT HINGED ANY SIZE KNEE BRACE NYLON KNEE BRACE RIGID KNEE SUPPORT- NEOPRENE MEDISENSE ELECTRODES MEDISENSE LANCETS MEDISURE LANCETS MICROLET LANCETS MONOJECT 1/2CC MONOJECT 1CC MONOJECT 3/10CC MONOJECT INSULIN SYRINGE 29G 1/2CC MONOJECT INSULIN SYRINGE 29G 1CC MONOJECT INSULIN SYRINGE 29G 3/10CC MONOJECT LANCETS MONOJECT LANCETS DEVICE MONOLET LANCETS (SHERWOOD) MONTMED MONTKIDDY PEN NEEDLES (32G) MONTMED PEN NEEDLE (31G) MONTMED PEN NEEDLE (32G) MONTMED SYRINGE (32G) NIT COMB NORMAL SALINE NOVA T IUD NOVOFINE AUTOCOVER NEEDLE NOVOFINE NEEDLES - 28 G x 12 mm NOVOFINE NEEDLES - 30 G x 8 mm NOVOFINE NEEDLES - 30 G x 6 mm 4 of 7
5 NOVOFINE PLUS (32G) PEN NEEDLE NOVOLIN NEEDLE 30G NOVOTWIST - 32G NOVOTWIST - 30G ONE TOUCH DELICA LANCETS OPTICHAMBER OPTICHAMBER MASK LARGE OPTICHAMBER MASK S/M OPTIHALER ORAL MEDICATION SYRINGE PAMPERS BABY DRY JUMBO SZ PAMPERS BABY DRY JUMBO SZ PEE DEE DOSE 5/10ML PEE-DEE DOSE ORAL SYRINGE 5ML PENLET (LIFESCAN) LANCETS PENLET 2 BLOOD SAMPLER PENLET PLUS ADJ BLOOD SAMPLER PINK LADY PODS (FOR OMNIPOD) PRECISION LANCETS 28G FREESTLYE PRECISION XTRA BLOOD KETONE PROMISE BRIEF LGE (16) PROMISE BRIEF MED (20) PROMISE DAY PLUS-18S PROMISE MAXIPADS (20) SERENITY GUARDS SLING (ARM) SOFT INS SYR 29 X SOFT TOUCH DEVICE SOFT TOUCH LANCETS SOFTCLIX BLOOD LETTING DEVICE SOFTCLIX SELECT LANCET SPACE CHAMBER SPIRIT LANCETS SURECOMFORT PEN NEEDLE - 29G SURECOMFORT PEN NEEDLE - 30G SURECOMFORT PEN NEEDLE - 31G SURECOMFORT PEN NEEDLE - 32G SURECOMFORT SYRINGE - 28G SURECOMFORT SYRINGE - 29G SURECOMFORT SYRINGE - 30G SURECOMFORT SYRINGE - 31G SURETEST LANCET 5 of 7
6 TEAR GEL TENA BRIEF NT LG TENA BRIEF ULTRA LG TENA BRIEF XL TENA PAD DAY PLUS TENA PAD DAY REGULAR TENA UNDERWARE PROT ANYSIZE TES-TAPE THERMOMETER ORAL REGULAR TRANQUILITY ADULT BRIEF LG TRANQUILITY ADULT BRIEF MED TRANQUILITY ADULT BRIEF SM TRANQUILITY ADULT BRIEF XLG TRANQUILITY BRIEF YOUTH ULTICARE SYRINGES 29-3/10CC ULTICARE SYRINGES 29G-1/2CC ULTICARE SYRINGES 29G-1CC ULTICARE SYRINGES 30G-1/2CC ULTICARE SYRINGES 30G-1CC ULTICARE SYRINGES 30G-3/10CC ULTICARE 28G SYRINGE ULTICARE 30G SYRINGE ULTICARE 31G SYRINGE ULTICARE LOW DEAD SPACE SYRINGE ULTICARE 29G SYRINGE WITH ULTIGUARD ULTICARE 30G SYRINGE WITH ULTIGUARD ULTICARE 31G SYRINGE WITH ULTIGUARD ULTICARE 29G PEN NEEDLE ULTICARE 31G PEN NEEDLE ULTICARE 32G (4MM) PEN NEEDLE ULTILET CLASSIC LANCETS ULTRA FINE NANO (32G) ULTRA SOFT LANCET ULTRA-FINE NANO ULTRA-FINE SYRINGE 3/ UNDERPAD CURAD UNIFINE PENTIPS 29G-12MM UNIFINE PENTIPS 31G-6MM UNIFINE PENTIPS 31G-8MM UNILET LANCETS WRIST BRACE #33 (FUT) WRIST BRACE RIGID WRIST BRACE WRAPAROUND 6 of 7
7 NON-STERILE COMPOUND STERILE COMPOUND STERILE COMPOUND (to be used if the total preparation time exceeds 15 minutes) ELIGIBLE COMPOUND (contains any amount of Ketamine) INELIGIBLE COMPOUND (contains any amount of Ketamine) ELIGIBLE COMPOUND (contains any amount of one or more drugs listed on the Monitored Drugs Compound List) INELIGIBLE COMPOUND (contains any amount of one or more drugs listed on the Monitored Drugs Compound List) INELIGIBLE COMPOUND 7 of 7
PIN List. Product Name
PIN List 909661 ABDOMINAL PAD 907622 ACCU-CHEK AVIVA BLOOD GLUCOSE TEST STRIPS 977999 ACCU-CHEK COMPACT BLOOD GLUCOSE TEST STRIPS 977993 ACCU-CHEK EASY BLOOD GLUCOSE TEST STRIPS 900418 ACCU-CHEK MOBILE
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Diabetic Test Strips PIN Description 97799824 ACCU-CHEK ADVANTAGE STRIPS (100) 97799823 ACCU-CHEK ADVANTAGE STRIPS (50) 97799814 ACCU-CHEK AVIVA TEST STRIPS (100) 97799815 ACCU-CHEK AVIVA TEST STRIPS (50)
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Appendix H Product Identification Number (PIN) DIN Code Brand Name Canadian Product Name 00999997 99 EXTEMPOR. CPDS - NFLD- 00977062 ACCU-CHEK ADVANTAGE TEST ACCU-CHEK ADVANTAGE TEST 00977124 ACCU-CHEK
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