INCONT LINER SERENITY EXTRA (15019)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER SERENITY EXTRA
VA GENERIC NAME PAD
DOSAGE FORM PAD
NATIONAL FORMULARY NAME PAD 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 INCONT LINER SERENITY EXTRA
VA PRODUCT IDENTIFIER XZ120
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4015383
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE