INCONT LINER MOLIMED 5.5IN X 10IN (17863)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER MOLIMED 5.5IN X 10IN
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 MOLIMED 5.5IN X 10IN
VA PRODUCT IDENTIFIER XV116
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4025550
EFFECTIVE DATE/TIME
  • 2006-09-05 00:00:00
    STATUS:   ACTIVE