LEG BAG COMBINATION PACK H#9622 (11864)    VA PRODUCT (50.68)

Name Value
NAME LEG BAG COMBINATION PACK H#9622
VA GENERIC NAME BAG
DOSAGE FORM MISCELLANEOUS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2001-01-16 00:00:00
DSS NUMBER 40
NATIONAL FORMULARY NAME BAG MISCELLANEOUS
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 LEG BAG COMBINATION PACK H#9622
VA PRODUCT IDENTIFIER XX057
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012230
EFFECTIVE DATE/TIME
  • 2001-01-16 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE