GASTROSTOMY TUBE HOLDER DALE #340 (13837)    VA PRODUCT (50.68)

Name Value
NAME GASTROSTOMY TUBE HOLDER DALE #340
VA GENERIC NAME SUPPLY
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME SUPPLY MISCELLANEOUS
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 GASTROSTOMY TUBE HOLDER DALE #340
VA PRODUCT IDENTIFIER XX900
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014201
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE