POUCH COVER NU-HOPE #2512 (25730)    VA PRODUCT (50.68)

Name Value
NAME POUCH COVER NU-HOPE #2512
VA GENERIC NAME POUCH COVER
DOSAGE FORM POUCH COVER
NATIONAL FORMULARY NAME POUCH COVER POUCH COVER
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 POUCH COVER NU-HOPE #2512
VA PRODUCT IDENTIFIER XI054
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034480
EFFECTIVE DATE/TIME
  • 2015-05-22 00:00:00
    STATUS:   ACTIVE