
| Name | Value |
|---|---|
| NAME | FLANGE CAP,SUR-FIT C#4019-10 |
| VA GENERIC NAME | FLANGE CAP |
| DOSAGE FORM | MISCELLANEOUS |
| NATIONAL FORMULARY NAME | FLANGE CAP MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | FLANGE CAP,SUR-FIT C#4019-10 |
| VA PRODUCT IDENTIFIER | XX789 |
| TRANSMIT TO CMOP | YES |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4013856 |
| EFFECTIVE DATE/TIME |
|