CONDOM,NON-LATEX,LUBRICATED (16177)    VA PRODUCT (50.68)

Name Value
NAME CONDOM,NON-LATEX,LUBRICATED
VA GENERIC NAME CONDOM
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME CONDOM 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 CONDOM,NON-LATEX,LUBRICATED
VA PRODUCT IDENTIFIER XZ647
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4016540
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE