BRIEF,TRANQUILITY SMARTCORE X-LG #2314 (26176)    VA PRODUCT (50.68)

Name Value
NAME BRIEF,TRANQUILITY SMARTCORE X-LG #2314
VA GENERIC NAME DIAPER
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME DIAPER MISCELLANEOUS
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 BRIEF,TRANQUILITY SMARTCORE X-LG #2314
VA PRODUCT IDENTIFIER XI252
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034968
EFFECTIVE DATE/TIME
  • 2015-10-27 00:00:00
    STATUS:   ACTIVE