INCONT LINER FREE & ACTIVE SUPER #26972 (11889)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER FREE & ACTIVE SUPER #26972
VA GENERIC NAME PAD
DOSAGE FORM PAD
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 4
NATIONAL FORMULARY NAME PAD PAD
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 INCONT LINER FREE & ACTIVE SUPER #26972
VA PRODUCT IDENTIFIER XS879
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012255
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE