BELT,SUPPORT 4IN XX-LG NU-HOPE #2664-A (21250)    VA PRODUCT (50.68)

Name Value
NAME BELT,SUPPORT 4IN XX-LG NU-HOPE #2664-A
VA GENERIC NAME BELT
DOSAGE FORM BELT
NATIONAL FORMULARY NAME BELT BELT
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 BELT,SUPPORT 4IN XX-LG NU-HOPE #2664-A
VA PRODUCT IDENTIFIER XT255
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4029383
EFFECTIVE DATE/TIME
  • 2009-12-04 00:00:00
    STATUS:   ACTIVE