INCONT LINER MOLIMED 6.5IN X 13IN (17864)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER MOLIMED 6.5IN X 13IN
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 6.5IN X 13IN
VA PRODUCT IDENTIFIER XV117
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4025551
EFFECTIVE DATE/TIME
  • 2006-09-05 00:00:00
    STATUS:   ACTIVE