PASTE,BRAVA COLOPLAST #12050 (26389)    VA PRODUCT (50.68)

Name Value
NAME PASTE,BRAVA COLOPLAST #12050
VA GENERIC NAME SUPPLY
DOSAGE FORM PASTE
NATIONAL FORMULARY NAME SUPPLY PASTE
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 PASTE,BRAVA COLOPLAST #12050
VA PRODUCT IDENTIFIER XI315
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4035204
EFFECTIVE DATE/TIME
  • 2015-12-14 00:00:00
    STATUS:   ACTIVE