IRRIGATION,ANAL PERISTEEN KIT C#29129 (26440)    VA PRODUCT (50.68)

Name Value
NAME IRRIGATION,ANAL PERISTEEN KIT C#29129
VA GENERIC NAME IRRIGATION,ANAL
DOSAGE FORM KIT
NATIONAL FORMULARY NAME IRRIGATION,ANAL KIT
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 IRRIGATION,ANAL PERISTEEN KIT C#29129
VA PRODUCT IDENTIFIER XI335
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035262
EFFECTIVE DATE/TIME
  • 2015-12-30 00:00:00
    STATUS:   ACTIVE