TISSEEL VHSD TWO COMPONENT FIBRIN SEALANT KIT 10ML (25123)    VA PRODUCT (50.68)

Name Value
NAME TISSEEL VHSD TWO COMPONENT FIBRIN SEALANT KIT 10ML
VA GENERIC NAME TISSEEL
DOSAGE FORM KIT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME TISSEEL KIT
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 TISSEEL VHSD 2-COMPONENT KIT 10ML
VA PRODUCT IDENTIFIER T0879
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033801
EFFECTIVE DATE/TIME
  • 2014-10-28 00:00:00
    STATUS:   ACTIVE