| NAME |
GLOVE LATEX MEDIUM CHEMO 18 MIL KEN#CT1092-1 (PAIR) |
| VA GENERIC NAME |
GLOVE |
| DOSAGE FORM |
GLOVE |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
GLOVE GLOVE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
GLOVE LATEX MED CHEMO KEN#CT1092-1 (PR) |
| VA PRODUCT IDENTIFIER |
XT404 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4029594 |
| EFFECTIVE DATE/TIME |
-
- 2010-02-09 00:00:00
- STATUS: ACTIVE
|
