POWDER,STOMAHESIVE C#0255-10,30GM (10253)    VA PRODUCT (50.68)

Name Value
NAME POWDER,STOMAHESIVE C#0255-10,30GM
VA GENERIC NAME STOMAHESIVE POWDER
DOSAGE FORM POWDER
HAZARDOUS TO DISPOSE NO
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 1
NATIONAL FORMULARY NAME STOMAHESIVE POWDER POWDER
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POWDER,STOMAHESIVE C#0255-10
VA PRODUCT IDENTIFIER XS584
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4010626
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE