| NAME |
GLUCOSE SENSOR DEXCOM G4-G5 |
| VA GENERIC NAME |
GLUCOSE SENSOR |
| DOSAGE FORM |
MISCELLANEOUS |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2022-06-15 00:00:00 |
| NATIONAL FORMULARY NAME |
GLUCOSE SENSOR MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
GLUCOSE SENSOR DEXCOM G4-G5 |
| VA PRODUCT IDENTIFIER |
XI431 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035484 |
| EFFECTIVE DATE/TIME |
-
- 2016-03-14 00:00:00
- STATUS: ACTIVE
-
- 2022-06-15 00:00:00
- STATUS: INACTIVE
|
