DIALYSATE,PRISMASATE BGK4/2.5 SOLN (24231)    VA PRODUCT (50.68)

Name Value
NAME DIALYSATE,PRISMASATE BGK4/2.5 SOLN
VA GENERIC NAME PRISMASATE
DOSAGE FORM SOLN,DIALYSIS
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME PRISMASATE SOLN,DIALYSIS
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 DIALYSATE,PRISMASATE BGK4/2.5 SOLN
VA PRODUCT IDENTIFIER D0991
TRANSMIT TO CMOP NO
VA DISPENSE UNIT BAG
MASTER ENTRY FOR VUID YES
VUID 4032779
EFFECTIVE DATE/TIME
  • 2013-10-15 00:00:00
    STATUS:   ACTIVE