Prescribing Info

How to Fill Dexcom G5® Mobile CGM Pharmacy Prescription

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The first prescription should include three items: 1 receiver, 1 wireless transmitter, and 1 four-pack of sensors.

1 Receiver

(Indicated for one-year use)

Black Receiver NDC: 08627-0090-11
Available in Classic Black
Displays glucose trends in three colors showing when glucose is high, low, or within range.
Refill once per year.
The Dexcom G5 Mobile Continuous Glucose Monitoring (CGM) System is indicated for ages 2 years and older.

1 Wireless Transmitter

(Indicated for three-month use)

Transmitter NDC: 08627-0014-01
Fastened on top of the sensor and wirelessly sends data to the receiver or compatible smart device.
Refill every 3 months.

1 Four-Pack of Sensors

(28-day supply)

Sensor Pack NDC: 08627-0051-04
Discreetly worn under clothing to measure glucose levels just underneath the skin.
Refill every 28 days.
With a seven-day sensor life, patients will need to replace sensors once a week.

How to Fill

Filling an Rx for Dexcom CGM is easy and timely.

Dexcom CGM supplies are available via next-business-day delivery through your wholesaler.

Patients who do not have a pharmacy benefit should follow up with Dexcom for a DME benefit coverage check:

Toll-free phone: 1-888-738-3646 (Monday - Friday, 6 a.m. to 5 p.m., PT; Saturday, 8 a.m. to 12 p.m., PT)

Toll-free fax: 1-877-633-9266

Email: CustomerService@dexcom.com

More Prescribing Info

Prescribe Dexcom G6 for your intensive insulin therapy patients. See the sample prescription below.

The first prescription should include three items: 1 receiver, 1 wireless transmitter, and 1 three-pack of sensors.

1 Receiver

(Indicated for one-year use)

Required documentation for prescribing CGM to Medicare patients

When prescribing a Dexcom CGM System to a Medicare patient, the Certificate of Medical Necessity is a required part of the document package for Medicare reimbursement. This form...