
| Name | Value |
|---|---|
| NAME | GASKET,SEAL-TITE 3.75IN,#TSN4302 |
| VA GENERIC NAME | DISC |
| DOSAGE FORM | MISCELLANEOUS |
| NATIONAL FORMULARY NAME | DISC MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | GASKET,SEAL-TITE 3.75IN,#TSN4302 |
| VA PRODUCT IDENTIFIER | XV366 |
| TRANSMIT TO CMOP | YES |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4026307 |
| EFFECTIVE DATE/TIME |
|