GLOVE NITRILE SMALL PWDR-FREE NONSTERILE TEXTURED (21662)    VA PRODUCT (50.68)

Name Value
NAME GLOVE NITRILE SMALL PWDR-FREE NONSTERILE TEXTURED
VA GENERIC NAME GLOVE
DOSAGE FORM GLOVE
NATIONAL FORMULARY NAME GLOVE GLOVE
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 GLOVE NITRILE SM PFREE NSTERL TX
VA PRODUCT IDENTIFIER XT555
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4029831
EFFECTIVE DATE/TIME
  • 2010-05-12 00:00:00
    STATUS:   ACTIVE