A BULLETIN FOR PHARMACY SERVICE PROVIDERS FROM …

1 A B U L L E T I N F O R P H A R M A C Y S E R V I C E P R O V I D E R S F R O M A L B E R T A B L U E C R O S SNumber 298 March 2011continued on of Pseudo Product Identification Numbers A list of pseudo Product Identification Numbers (PINs) is featured in this Benefact for your reference. When billing indicated products to Alberta Blue Cross, please use the appropriate PIN. Note these products may not be eligible for coverage through all of your customers plans. Contact Alberta Blue Cross PHARMACY services in instances where you are uncertain whether a customer is eligible for coverage of such SUPPLIESPRODUCT DESCRIPTIONPINPRODUCT DESCRIPTIONPINALCOHOL DEXT/ NACL (2/3-1/3) DEXT/ NACL/ 20 MEQ KCL DEXT/ NACL/ 40 MEQ KCL INJECTION00990038IV SOLUTIONS009900225% DEXTROSE (D5W)

2 INJECTION00990033IV TUBING009900215% DEXTROSE/ KCL 20 MEQ INJECTION00990035 NEEDLES009900195% DEXTROSE/ KCL 40 MEQ INJECTION00990036 SYRINGES00990020 LACTATED RINGER S SODIUM CHLORIDE INJECTION00990040 DIABETES SUPPLIESPRODUCT DESCRIPTIONPINPRODUCT DESCRIPTIONPINALCOHOL SWABS-DIABETES00999984 INSULIN INJECTORS00990030 BLOOD GLUCOSE METER00990024 INSULIN PEN NEEDLES00999985 BLOOD GLUCOSE TEST STRIPS00999955 INSULIN PUMPS00999988 BLOOD KETONE TEST STRIPS00990072 INSULIN SYRINGES00999952 BLOOD LETTING LANCET00999941 LANCING DEVICE00999942 COTTON SWABS-DIABETES00990064 NEEDLELESS SYRINGE FOR INSULIN INJECTOR00999017 GLUCOSE CALIBRATION SOLUTION00990058 RUBBING ALCOHOL-DIABETES00990065 GLUCOSE MONITORING TRANSMITTER00999471 SYRINGE/VIAL ADAPTER KIT FOR INSULIN INJEC-TOR00999018 GLUCOSE MONITORING TRANSMITTER SENSORS00999472 URINE TEST STRIPS00999957 INFUSION SETS (TUBING & NEEDLE)

3 00990045 VIAL ADAPTER/ADAPTER CAP FOR INSULIN INJECTOR00999016 INSULIN CARTRIDGES00990057 MISCELLANEOUSPRODUCT DESCRIPTIONPINPRODUCT DESCRIPTIONPINMETHADONE ORAL LIQUID00999995 ALLERGY SERUM INJECTION00999981 NUTRITIONAL PRODUCTSPRODUCT DESCRIPTIONPINPRODUCT DESCRIPTIONPINBENEPROTEIN ORAL POWDER00999415 NOVASOURCE RENAL LIQUID00990056 BOOST STANDARD ORAL LIQUID00999960 NUTRAMIGEN A+ HYPOALLERGENIC INFANT FORMULA LIQUID00999521 BOOST PLUS CALORIES ORAL LIQUID00999932 NUTRAMIGEN A+ HYPOALLERGENIC INFANT FORMULA POWDER00999520 BOOST DIABETIC ORAL LIQUID00999483 NUTRAMIGEN AA INFANT FORMULA POWDER00999543 BOOST FRUIT FLAVOURED BEVERAGE ORAL LIQUID00999402 NUTREN ORAL LIQUID00999936 BOOST HIGH PROTEIN ORAL LIQUID00999427 NUTREN ORAL LIQUID00999964 BOOST ORAL LIQUID00999920 NUTREN JUNIOR FIBRE WITH PREBIO 1 ORAL LIQUID00999419 BOOST ORAL PUDDING00999440 NUTREN JUNIOR ORAL LIQUID00999418 BOOST PLUS CALORIES ORAL LIQUID00999921 NUTRIHEP ORAL LIQUID00999347 COMPLEAT ORAL LIQUID00999966 OPTIMENTAL ORAL LIQUID00999420 COMPLEAT PEDIATRIC ORAL LIQUID00999426 PEDIASURE PLUS WITH FIBRE ORAL LIQUID00999434 CONSIST-RITE ORAL POWDER00999455 PEDIASURE WITH FIBRE ORAL LIQUID00990029 DUOCAL ORAL POWDER00999444 PEPTAMEN ORAL LIQUID00999421E028 SPLASH ORAL LIQUID00999524 PEPTAMEN AF ORAL LIQUID00999467 ENSURE00999901 PEPTAMEN JUNIOR ORAL LIQUID00999553 ENSURE HIGH-PROTEIN

4 ORAL LIQUID00999934 PEPTAMEN JUNIOR ORAL LIQUID00999408 ENSURE LIQUID WITH FIBRE00999918 PEPTAMEN ORAL LIQUID00999944 ENSURE ORAL PUDDING00999404 PEPTAMEN WITH PREBIO 1 ORAL LIQUID00999435 ENSURE PLUS00999902 PERATIVE ORAL LIQUID00999423 ENSURE PREBIOTICS ORAL LIQUID 00999525 POLYCOSE ORAL POWDER00999928 GLUCERNA ORAL LIQUID00999940 PULMOCARE ORAL LIQUID00999412 ISOSOURCE CAL ORAL LIQUID00999425 RESOURCE ORAL LIQUID00999409 ISOSOURCE HN ORAL LIQUID00999410 RESOURCE DAIRY THICK ORAL LIQUID00999469 ISOSOURCE HN WITH FIBRE ORAL LIQUID00999424 RESOURCE DIABETIC ORAL LIQUID00999413 ISOSOURCE VHN ORAL LIQUID00999428 RESOURCE JUST FOR KIDS CAL WITH FIBRE LIQUID00999458 ISOSOURCE VHP FIBRE-FREE ORAL LIQUID00999550 RESOURCE KID ESSENTIALS ORAL LIQUID00999551 jevity 1 CAL ORAL LIQUID00999938 RESOURCE THICKENED JUICE ORAL LIQUID00999429 jevity CAL ORAL LIQUID00999416 RESOURCE THICKENUP ORAL POWDER00999453 jevity CAL ORAL LIQUID00999475 SCANDISHAKE ORAL FOOD SUPPLEMENT POWDER00999935 KETOCAL ORAL POWDER00999445 SIMILAC ADVANCE NEOSURE ORAL POWDER00999465 MCT OIL ORAL LIQUID00999927 SIMILAC ALIMENTUM WITH IRON ORAL INFANT FORMULA00999449 NEOCATE JUNIOR ORAL POWDER00999447 SUPLENA ORAL LIQUID00999414 NEOCATE ORAL INFANT FORMULA00999456 TOLEREX ORAL POWDER00999929 NEPRO CARB STEADY ORAL LIQUID00999545 TWOCAL HN ORAL LIQUID00999430 NEPRO ORAL LIQUID00999922 VITAL HN

5 ORAL POWDER00999965 OSMOLITE CAL ORAL LIQUID00999552 VIVONEX PEDIATRIC ORAL POWDER00999422 OSMOLITE HN ORAL LIQUID00999937 VIVONEX PLUS ORAL POWDER00999405 PEDIASURE ORAL LIQUID00999933 VIVONEX ORAL POWDER00999983continued on next HOLDING CHAMBER/MASK DEVICEPRODUCT DESCRIPTIONPINPRODUCT DESCRIPTIONPINADULT AEROCHAMBER MAX WITH MASK DEVICE00990085 POCKET CHAMBER DEVICE00990067 AEROCHAMBER AC BOYZ CHAMBER00990089 POCKET CHAMBER PEDIATRIC LARGE MASK DEVICE00990070 AEROCHAMBER AC GIRLZ CHAMBER00990088 POCKET CHAMBER PEDIATRIC MEDIUM MASK DEVICE00990069 AEROCHAMBER MAX DEVICE00990084 POCKET CHAMBER PEDIATRIC SMALL MASK DEVICE00990068 AEROCHAMBER PLUS FLOW-VU W/ LARGE MASK00990094 POCKET SPACER DEVICE00990066 AEROCHAMBER PLUS FLOW-VU W/ MEDIUM MASK00990093 PRIMEAIRE ADULT LARGE MASK DEVICE00990078 AEROCHAMBER PLUS FLOW-VU W/ SMALL MASK00990092 PRIMEAIRE ADULT MEDIUM MASK DEVICE00990077 AEROCHAMBER PLUS FLOW-VU W/ MOUTH-PIECE00990091 PRIMEAIRE ADULT SMALL MASK DEVICE00990076 CHILD AEROCHAMBER MAX WITH MASK DE-VICE00990086 PRIMEAIRE DEVICE00990074 INFANT AEROCHAMBER MAX WITH MASK DEVICE00990087 PRIMEAIRE PEDIATRIC MASK DEVICE00990075 OPTICHAMBER ADVANTAGE II (CHAMBER ONLY)00990095 SEREVENT DISKHALER DEVICE00999949 OPTICHAMBER ADVANTAGE II (WITH LARGE MASK)00990098 SPACE CHAMBER ADULT MASK DEVICE00990017 OPTICHAMBER ADVANTAGE II (WITH MEDIUM MASK)

6 00990097 SPACE CHAMBER DEVICE00990014 OPTICHAMBER ADVANTAGE II (WITH SMALL MASK)00990096 SPACE CHAMBER INFANT MASK DEVICE00990015 OPTICHAMBER DEVICE00990059 SPACE CHAMBER PEDIATRIC MASK DEVICE00990016 OPTICHAMBER LARGE FACE MASK DEVICE00990061 VORTEX BABY WHIRL INFANT MASK DEVICE00990081 OPTICHAMBER MEDIUM FACE MASK DEVICE00990062 VORTEX DEVICE00990080 OPTICHAMBER SMALL FACE MASK DEVICE00990063 VORTEX SPINNER PEDIATRIC MASK DEVICE00990082 OPTIHALER DEVICE00990060 For more information on PHARMACY topics, please contact your PHARMACY services representatives at: 780-498-8370 (Edmonton and area) FAX 780-498-8406 403-294-4041 (Calgary and area) (Edmonton and area)1-800-361-9632 (toll free) FAX 1-877-305-9911 (toll free) The Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross Plans, an association of independent Blue Cross plans.

7 Licensed to ABC Benefits Corporation for use in operating the Alberta Blue Cross Plan. ABC 2011/03