TECHNETIUM TC99M TETROFOSMIN KIT (25536)    VA PRODUCT (50.68)

Name Value
NAME TECHNETIUM TC99M TETROFOSMIN KIT
VA GENERIC NAME TECHNETIUM
DOSAGE FORM INJ
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME TECHNETIUM INJ
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 TECHNETIUM TC99M TETROFOSMIN KIT
VA PRODUCT IDENTIFIER T0889
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4034262
EFFECTIVE DATE/TIME
  • 2015-03-10 00:00:00
    STATUS:   ACTIVE