LEG BAG 4 PACK H#9835 (13045)    VA PRODUCT (50.68)

Name Value
NAME LEG BAG 4 PACK H#9835
VA GENERIC NAME BAG
DOSAGE FORM BAG
NATIONAL FORMULARY NAME BAG BAG
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 4 PACK H#9835
VA PRODUCT IDENTIFIER XX559
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PKG
MASTER ENTRY FOR VUID YES
VUID 4013410
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE