PAD,OSTOMY PROTEX POWDER MARLEN #112D (14520)    VA PRODUCT (50.68)

Name Value
NAME PAD,OSTOMY PROTEX POWDER MARLEN #112D
VA GENERIC NAME SUPPLY
DOSAGE FORM PAD
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME SUPPLY PAD
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 PAD,OSTOMY PROTEX POWDER MARLEN #112D
VA PRODUCT IDENTIFIER XY311
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014884
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE