PAD,FOAM 0.5IN X 18IN X 72IN BIACARE #5302 (26651)    VA PRODUCT (50.68)

Name Value
NAME PAD,FOAM 0.5IN X 18IN X 72IN BIACARE #5302
VA GENERIC NAME PAD,FOAM
DOSAGE FORM PAD
NATIONAL FORMULARY NAME PAD,FOAM PAD
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 PAD,FOAM 0.5 X 18 X 72IN BIACARE #5302
VA PRODUCT IDENTIFIER XI434
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035487
EFFECTIVE DATE/TIME
  • 2016-03-14 00:00:00
    STATUS:   ACTIVE