CONDOM,LATEX,SPERMICIDAL (26602)    VA PRODUCT (50.68)

Name Value
NAME CONDOM,LATEX,SPERMICIDAL
VA GENERIC NAME CONDOM
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME CONDOM 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 CONDOM,LATEX,SPERMICIDAL
VA PRODUCT IDENTIFIER XI416
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035437
EFFECTIVE DATE/TIME
  • 2016-02-25 00:00:00
    STATUS:   ACTIVE