LEG BAG SECURITY+ CONVEEN C#5161 (16202)    VA PRODUCT (50.68)

Name Value
NAME LEG BAG SECURITY+ CONVEEN C#5161
VA GENERIC NAME BAG,LEG
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME BAG,LEG 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 LEG BAG SECURITY+ CONVEEN C#5161
VA PRODUCT IDENTIFIER XZ661
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4016565
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE