WAFER,SUR-FIT,STOMAHESIVE,2-1/4IN C#4014-31 (14242)    VA PRODUCT (50.68)

Name Value
NAME WAFER,SUR-FIT,STOMAHESIVE,2-1/4IN C#4014-31
VA GENERIC NAME STOMAHESIVE WAFER
DOSAGE FORM WAFER
NATIONAL FORMULARY NAME STOMAHESIVE WAFER WAFER
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 WAFER,SUR-FIT,STOMAHES,2-1/4IN C#4014-31
VA PRODUCT IDENTIFIER XY154
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014606
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE