DIAPHRAGM,CAYA CONTOURED (26191)    VA PRODUCT (50.68)

Name Value
NAME DIAPHRAGM,CAYA CONTOURED
VA GENERIC NAME DIAPHRAGM
DOSAGE FORM DIAPHRAGM
NATIONAL FORMULARY NAME DIAPHRAGM DIAPHRAGM
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 DIAPHRAGM CAYA CONTOURED
VA PRODUCT IDENTIFIER XI267
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034983
EFFECTIVE DATE/TIME
  • 2015-10-28 00:00:00
    STATUS:   ACTIVE