| NAME |
KANGAROO PUMP SET EASY-CAP CLOSE 500ML ENFIT COVIDIEN #712004 |
| VA GENERIC NAME |
KIT |
| DOSAGE FORM |
SET |
| NATIONAL FORMULARY NAME |
KIT SET |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
KANGAROO PMP SET EZ-CAP CLSE 500ML ENFIT |
| VA PRODUCT IDENTIFIER |
XI196 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034847 |
| EFFECTIVE DATE/TIME |
-
- 2015-09-29 00:00:00
- STATUS: ACTIVE
|
