Core List F January 2022 GMS Codes - HSE.ie

1 Core List F(Diabetes Mellitus)April 2022 atclvl5 Non proprietary DrugCde DmaDrug DescriptionPack Size NamePackSizeType IllnessA10AB01 INSULIN (HUMAN), FAST ACTING62006 Actrapid Vial 100 IU/ml. 10 ml. Vial 11 X 10ML1FA10AB01 INSULIN (HUMAN), FAST ACTING53489 Apidra SoloStar ( Mfg.) Soln. for Inj. 100 units/ml. 3 ml. 55 X 3 ML5FA10AB01 INSULIN (HUMAN), FAST ACTING69169 Humulin S Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AB01 INSULIN (HUMAN), FAST ACTING69077 Humulin S Vial 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AB04 INSULIN LISPRO FAST-ACTING69091 Humalog Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AB04 INSULIN LISPRO FAST-ACTING41046 Humalog Junior Kwikpen Soln. for Inj. in Pre-Filled Pen 100 units/ml.

2 3 ml. 53 ML X 55FA10AB04 INSULIN LISPRO FAST-ACTING41045 Humalog KwikPen ( Mfg.) 100 IU/ml. 3 ml. Pre-filled Pen 53 ML X 55FA10AB04 INSULIN LISPRO FAST-ACTING69132 Humalog Kwikpen 100 IU/ml. 3 ml. Pre-filled Pen 53 ML X 55FA10AB04 Insulin Lispro Fast-Acting69184 Humalog Kwikpen 200 IU/ml. 3 ml. Pre-filled Pen 53 ML X 55FA10AB04 INSULIN LISPRO FAST-ACTING69050 Humalog Vial 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AB05 Insulin Aspart43903 Fiasp FlexTouch Soln. for Inj. Prefilled Pen 100 IU/ml. 3 ml. 53 ML X 55FA10AB05 Insulin Aspart43911 Fiasp Penfill Soln. for Inj. Cartridge 100 IU/ml. 3 ml. 53 ML X 55FA10AB05 Insulin Aspart43919 Fiasp PumpCart Soln. for Inj. Cartridge 100 units/ml. ml. ML X 55FA10AB05 Insulin Aspart43918 Fiasp Soln.

3 For Inj. Vial 100 IU/ml. 10 ml. 11 X 10 ML1FA10AB05 INSULIN ASPART, FAST-ACTING62720 NovoRapid ( Mfg.) FlexPen 100 IU/ml. 3 ml. Pre-filled Pen 55 X 3ML5FA10AB05 INSULIN ASPART, FAST-ACTING62730 NovoRapid ( Mfg.) Penfill Cartidge 100 IU/ml. 3 ml. Cartridge 55 X 3ML5FA10AB05 INSULIN ASPART FAST-ACTING62710 NovoRapid ( Mfg.) Soln. for Inj. 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AB05 INSULIN ASPART, FAST-ACTING62709 NovoRapid FlexPen 100 IU/ml. 3 ml. Pre-filled Pen 55 X 3 ML5FA10AB05 INSULIN ASPART, FAST-ACTING63121 NovoRapid Penfill Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AB05 INSULIN ASPART FAST-ACTING73541 NovoRapid Vial 100 IU/ml. 10 ml. Vial 11X 10 ML1FA10AB06 INSULIN GLULISINE FAST-ACTING69335 Apidra Cartridge 100 IU/ml.

4 3 ml. 15 X 3 ML5FA10AB06 INSULIN GLULISINE FAST-ACTING69398 Apidra SoloStar Soln. for Inj. 100 units/ml. 3 ml. 55 X 3 ML5FA10AB06 INSULIN GLULISINE FAST-ACTING69376 Apidra Vial 100 IU/ml. 10 X 10 ML1FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING69100 Humulin I Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING69337 Humulin I kwikpen 100 iu/ml. 3 ml. Pre-filled Pen 55 X 3 ML5FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING69069 Humulin I Vial 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING71512 Insulatard InnoLet Pre-filled Syringe 100 IU/ml. 3 ml. Syringe 55 X 3 ML5FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING71580 Insulatard Penfill Cartridge 100 IU/ml.

5 3 ml. Cartridge 55 X 3 ML5FA10AC01 INSULIN (HUMAN) INTERMEDIATE-ACTING61786 Insulatard Vial 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AD01 INSULIN (HUMAN) INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING69137 Humulin M3 Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AD01 INSULIN (HUMAN) INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING69312 Humulin M3 Kwikpen 100 IU/ml. 3 ml. Pre-filled Pen 53 ML. X 55FA10AD01 INSULIN (HUMAN) INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING69183 Humulin M3 Vial 100 IU/ml. 10 ml. Vial 11 X 10ML1FA10AD01 Insulin (Human) Intermediate-Acting68032 Insuman Comb 50 Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AD05 INSULIN ASPART INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING64275 NovoMix ( Mfg.)

6 30 Penfill 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AD05 INSULIN ASPART INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING68930 NovoMix 30 ( Mfg.) FlexPen 100 IU/ml. 3 ml. Pre-filled Pen 55 X 3ML5FA10AD05 INSULIN ASPART INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING76140 NovoMix 30 FlexPen 100 IU/ml. 3 ml. Pre-filled Pen 55 X 3 ML5FA10AD05 INSULIN ASPART INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING68927 NovoMix 30 Penfill Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AD30 INSULIN COMBINATIONS, INTERMEDIATE ACTING COMBINED WITH FAST-ACTING69105 Humalog Kwikpen Mix 25 100 IU/ml. 3 ml. Pre-filled Pen 53 ML X 55FA10AD30 INSULIN COMBINATIONS, INTERMEDIATE ACTING COMBINED WITH FAST-ACTING69148 Humalog Kwikpen Mix 50 100 IU/ml.

7 3 ml. Pre-filled Pen 53 ML X 55FA10AD30 INSULIN COMBINATIONS, INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING69001 Humalog Mix 25 Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AD30 INSULIN COMBINATIONS, INTERMEDIATE-ACTING COMBINED WITH FAST-ACTING69057 Humalog Mix 50 Cartridge 100 IU/ml. 3 ml. Cartridge 55 x 3 Glargine69486 Abasaglar KwikPen Soln. for Inj., Pre-Filled Pen 100 units/ml. 3 ml. 5 (1 - 80 Units)5 X 3 ML5FA10AE04 INSULIN GLARGINE, LONG-ACTING26953 Lantus ( Mfg.) Soln. for Inj. 100 units/ml. 3 ml. 55 X 3ML5FA10AE04 INSULIN GLARGINE LONG-ACTING69158 Lantus Cartridge 100 IU/ml. 3 ml. Cartridge 55 X 3 ML5FA10AE04 INSULIN GLARGINE, LONG-ACTING69207 Lantus Solostar ( Mfg.) Soln for Inj.

8 100 units/ml. 3 ml. 55 X 3ML5FA10AE04 INSULIN GLARGINE LONG-ACTING69252 Lantus SoloStar Soln. for Inj. 100 units/ml. 3 ml. 55 X 3 ML5FA10AE04 INSULIN GLARGINE LONG-ACTING69277 Lantus Vial 100 IU/ml. 10 ml. Vial 11 X 10 ML1FA10AE04 Insulin Glargine31145 Toujeo DoubleStar Soln. for Inj. in Pre-filled Pen 300 units/ml. 33 X 3 ML3FA10AE04 Insulin Glargine41753 Toujeo SoloStar (Originalis ) Soln. for Inj. in Pre-filled Pen 300 units/ml. ml. 33 X ML3FA10AE04 INSULIN GLARGINE LONG-ACTING41752 Toujeo Solostar Soln. for Inj. in Pre-filled Pen 300 units/ml. ml. 55 X ML5FA10AE05 INSULIN DETEMIR, LONG-ACTING63015 Levemir ( Mfg.) Flexpen Pre-Filled Pen 100 units/ml. 3 ml. 55 X 3ML5FA10AE05 INSULIN DETEMIR, LONG-ACTING63005 Levemir ( Mfg.)

9 Penfill Cartridge 100 units/ml. 3 ml. 55 X 3ML5FA10AE05 INSULIN DETEMIR, LONG-ACTING63003 Levemir Flexpen Pre-Filled Pen 100 units/ml. 3 ml. 55 X 3 ML5FA10AE05 INSULIN DETEMIR LONG-ACTING63109 Levemir InnoLet 100 units/ml. 3 ml. 55 X 3 ML5FA10AE05 INSULIN DETEMIR, LONG-ACTING63082 Levemir Penfill Cartridge 100 units/ml. 3 ml. 55 X 3 Degludec72398 Tresiba (Originalis ) Flextouch Soln. for Inj. in Pre-filled Pen 200 iu/ml. 3 ml. 33 X 3 Degludec72386 Tresiba U100 FlexTouch Pre-filled Pen 100 iu/ml. 3 ml. 55 X 3 Degludec72390 Tresiba U200 FlexTouch Pre-filled Pen 200 iu/ml. 3 ml. 33 X 3 Degludec And Liraglutide29225 Xultophy Soln. for Inj. Pre-Filled Pen 100 unit/ml. + 3 ml. 33 X 3 of 26 Core List F(Diabetes Mellitus)April 2022 atclvl5 Non proprietary DrugCde DmaDrug DescriptionPack Size NamePackSizeType IllnessA10BA02 METFORMIN27742 Glucophage Tabs.

10 1000 mg. 606060FA10BA02 METFORMIN27723 Glucophage Tabs. 500 mg. 848484FA10BA02 METFORMIN27731 Glucophage Tabs. 850 mg. 565656FA10BA02 METFORMIN36820 Metformin (AuroBindo Pharma) Film Coated Tabs. 1000 mg. 606060FA10BA02 METFORMIN36823 Metformin (AuroBindo Pharma) Film Coated Tabs. 500 mg. 909090FA10BA02 METFORMIN36824 Metformin (AuroBindo Pharma) Film Coated Tabs. 850 mg. 606060FA10BA02 METFORMIN36832 Metformin (Bluefish) Film Coated Tabs. 1000 mg. 606060FA10BA02 METFORMIN36817 Metformin (Bluefish) Tabs. 1000 mg. 303030FA10BA02 METFORMIN36815 Metformin (Bluefish) Tabs. 500 mg. 848484FA10BA02 METFORMIN36816 Metformin (Bluefish) Tabs. 850 mg. 565656FA10BA02 METFORMIN37842 Metformin (PInewood) Film Coated Tabs.