WAFER,STOMAHESIVE W/FLANGE C#4019-25 (21174)    VA PRODUCT (50.68)

Name Value
NAME WAFER,STOMAHESIVE W/FLANGE C#4019-25
VA GENERIC NAME WAFER
DOSAGE FORM WAFER
NATIONAL FORMULARY NAME WAFER WAFER
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 WAFER,STOMAHESIVE W/FLANGE C#4019-25
VA PRODUCT IDENTIFIER XT210
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4029297
EFFECTIVE DATE/TIME
  • 2009-11-09 00:00:00
    STATUS:   ACTIVE