TAPE,MEPITAC SILICONE 1.5IN X 1.5YD #298400 (22153)    VA PRODUCT (50.68)

Name Value
NAME TAPE,MEPITAC SILICONE 1.5IN X 1.5YD #298400
VA GENERIC NAME TAPE
DOSAGE FORM TAPE
NATIONAL FORMULARY NAME TAPE TAPE
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 TAPE,SILICONE MEPITAC 1.5INX1.5YD#298400
VA PRODUCT IDENTIFIER T0759
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030405
EFFECTIVE DATE/TIME
  • 2011-02-09 00:00:00
    STATUS:   ACTIVE