DEPEND W/ELASTIC LEG X-ABSORB #19696 (15018)    VA PRODUCT (50.68)

Name Value
NAME DEPEND W/ELASTIC LEG X-ABSORB #19696
VA GENERIC NAME DIAPER
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME DIAPER 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 DEPEND W/ELASTIC LEG X-ABSORB #19696
VA PRODUCT IDENTIFIER XZ119
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4015382
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE