LOOP,CONSTRICTION ADJUSTABLE DEVICE ACTIS (20513)    VA PRODUCT (50.68)

Name Value
NAME LOOP,CONSTRICTION ADJUSTABLE DEVICE ACTIS
VA GENERIC NAME CONSTRICTION
DOSAGE FORM DEVICE
NATIONAL FORMULARY NAME CONSTRICTION DEVICE
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 LOOP,CONSTRICTION DEVICE ACTIS
VA PRODUCT IDENTIFIER XU785
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4028521
EFFECTIVE DATE/TIME
  • 2009-04-08 00:00:00
    STATUS:   ACTIVE