POISE PAD,ULTIMATE ABSORB EXTRA COVERAGE (25284)    VA PRODUCT (50.68)

Name Value
NAME POISE PAD,ULTIMATE ABSORB EXTRA COVERAGE
VA GENERIC NAME PAD
DOSAGE FORM PAD
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME PAD PAD
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 POISE PAD,ULTIMATE ABSORB EXTRA COVERAGE
VA PRODUCT IDENTIFIER XH846
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033979
EFFECTIVE DATE/TIME
  • 2014-12-23 00:00:00
    STATUS:   ACTIVE