BAG,LEG LARGE 25 OZ (DOVER) (26419)    VA PRODUCT (50.68)

Name Value
NAME BAG,LEG LARGE 25 OZ (DOVER)
VA GENERIC NAME BAG
DOSAGE FORM BAG
NATIONAL FORMULARY NAME BAG BAG
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 BAG,LEG LARGE 25 OZ DOVER
VA PRODUCT IDENTIFIER XI327
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035237
EFFECTIVE DATE/TIME
  • 2015-12-21 00:00:00
    STATUS:   ACTIVE