Product Details
FreeStyle Libre 3 Reader
Reader Kit And Sensor KitFlash Glucose Monitoring System - Reader
DIN/PIN/NPN
09858386
Manufacturer
Abbott Diabetes Care Ltd.
Formulary Listing Date
2025-11-28
Unit Price
NA
Amount MOH Pays
60.0000
Coverage Status
Flash Glucose Monitoring System
ODB Formulary Therapeutic Classification
Therapeutic Note
ATC Code
Interchangeable Products
NOLU Clinical Criteria
NORequirements
Reimbursement Criteria and Maximum Reimbursed Quantity:
All ODB eligible recipients on insulin therapy for diabetes who have a valid prescription
from a physician or nurse practitioner for CGM sensors and/or a CGM reader/receiver
designated on the Formulary are eligible to receive the prescribed ODB-funded CGM
sensors and/or reader/receiver.
Patients who meet the reimbursement criteria are eligible for a maximum reimbursed
quantity of 31 sensors over the course of a 365-day period.
Please refer to the Ontario Drug Programs Reference Manual for more information
related to CGM systems (e.g., pharmacy billing procedure, HNS response codes and
messages).