BAG,LEG LARGE KIT ROCHESTER #49401 (23513)    VA PRODUCT (50.68)

Name Value
NAME BAG,LEG LARGE KIT ROCHESTER #49401
VA GENERIC NAME BAG,LEG
DOSAGE FORM BAG
NATIONAL FORMULARY NAME BAG,LEG BAG
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 BAG,LEG LARGE KIT ROCHESTER #49401
VA PRODUCT IDENTIFIER XH147
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031976
EFFECTIVE DATE/TIME
  • 2013-01-23 00:00:00
    STATUS:   ACTIVE