
| Name | Value |
|---|---|
| NAME | LEG BAG COMBINATION PACK H#9825 |
| VA GENERIC NAME | BAG |
| DOSAGE FORM | MISCELLANEOUS |
| NATIONAL FORMULARY NAME | BAG MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | LEG BAG COMBINATION PACK H#9825 |
| VA PRODUCT IDENTIFIER | XX555 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | PKG |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4013304 |
| EFFECTIVE DATE/TIME |
|