GLUCOSE SENSOR DEXCOM SEVEN (21752)    VA PRODUCT (50.68)

Name Value
NAME GLUCOSE SENSOR DEXCOM SEVEN
VA GENERIC NAME GLUCOSE SENSOR
DOSAGE FORM MISCELLANEOUS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME GLUCOSE SENSOR MISCELLANEOUS
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 GLUCOSE SENSOR DEXCOM SEVEN
VA PRODUCT IDENTIFIER G0353
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4029933
EFFECTIVE DATE/TIME
  • 2010-07-12 00:00:00
    STATUS:   ACTIVE