BELT ADAPTER H#4202 (12085)    VA PRODUCT (50.68)

Name Value
NAME BELT ADAPTER H#4202
VA GENERIC NAME BELT
DOSAGE FORM BELT
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 18
NATIONAL FORMULARY NAME BELT BELT
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 BELT ADAPTER H#4202
VA PRODUCT IDENTIFIER XX014
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012451
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE