Byram dme order form

Intended for US Healthcare Providers Only.

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available at participating DME suppliers

DME = durable medical equipment

Follow 3 easy steps to prescribe the FreeStyle Libre 3 system:

  1. Select the DME supplier of your choice from the table below.
  2. Complete all fields on Standard Written Order for commercially insured patients.
  3. Submit the order and the patient’s most recent medical records that demonstrate medical necessity to the selected DME supplier that provides the FreeStyle Libre 3 system.

Refer your patients to one of the DME suppliers listed here:

DME SUPPLIER/EMAIL

PHONE/FAX

Advanced Diabetes Supply
LibreIntakes‌​@northcoastmed.com

P: 866-976-9110
F: 760-496-0234

Better Living Now
Libre@betterlivingnow.com

P: 800-854-5729
F: 877-262-2179

Bridgewater Health Supplies
info@bridgewaterhealthsupplies.com

P: 800-974-2055
F: 877-297-5127

Byram Healthcare/ Apria
AbbottReferrals‌​​@byramhealthcare.com

P: 800-775-4372
F: 866-387-1127

CCS Medical
Libre@ccsmed.com

P: 800-599-7521
F: 800-557-8256

Diabetes Management & Supplies/ AdaptHealth
referrals@diabetesms.com

P: 888-738-7929
F: 504-407-2083

Edgepark Medical Supplies
diabetesreferrals​​@cardinalhealth.com

P: 844-619-4650
F: 866-510-6583

Edwards Health Care Services
Libre@myehcs.com

P: 800-951-1725
F: 502-657-0237

J&B Medical Supply
providerservices@jandbmedical.com

P: 800-737-0045
F: 800-737-0012

Mini Pharmacy
info@minipharmacy.net

P: 888-545-6464
F: 800-280-2939

Quest Health Solutions
info@questhealthsolutions.com

P: 877-888-7050
F: 866-422-5283

Solara Medical Supplies/AdaptHealth
intakefaxes​@solaramedicalsupplies.com

P: 844-381-8032
F: 800-999-7021

Total Medical Supply
cgm@tmscares.com

P: 877-670-1120
F: 877-670-1121

United States Medical Supply
abbott@usmed.com

P: 877-270-6508
F: 866-347-8544

US HealthLink
customerservice@ushealthlink.com

P: 855-421-2732
F: 407-440-8122

FreeStyle Libre family of products may be available through other suppliers not listed who acquire these products indirectly.

This listing of participating suppliers are in alphabetical order and ADC has no preference on the supplier selected from the list. All DME suppliers who have contracted with ADC to acquire FreeStyle Libre family of products directly were eligible to be listed if they indicated they will supply continuous glucose monitors.

Now participating DME suppliers can fill FreeStyle Libre 3 system prescriptions for commercially
insured patients.

Questions? Contact our Customer Care Team at 855-632-8658 ​7 days a week
from 8AM to 8PM EST, excluding holidays.

At this time, FreeStyle Libre 3 is not currently eligible for Medicare reimbursement, and Medicaid eligibility may vary by state.

The FreeStyle Libre 3 app is only compatible with certain mobile devices and operating systems. Please check our compatibility guide for more information about device compatibility before using the app. Use of the FreeStyle Libre 3 app requires registration with LibreView.

ADC-55140 v2.0 09/22

Important Safety Information

FreeStyle Libre 14 day, FreeStyle Libre 2 and FreeStyle Libre 3 systems: Failure to use FreeStyle Libre systems as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If glucose reading and alarms (if enabled) do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at 855‑632‑8658 or FreeStyleLibre.us for safety info.

The product images are for illustrative purposes only.

The sensor housing, FreeStyle, Libre, and related brand marks are marks of Abbott. Other trademarks are the property of their respective owners.

No use of any Abbott trademark, trade name, or trade dress in this site may be made without prior written authorization of Abbott Laboratories, except to identify the product or services of the company.

This website and the information contained herein is intended for use by residents of the United States.