| NAME |
BREAST MILK STORAGE BAG |
| VA GENERIC NAME |
BREAST MILK |
| DOSAGE FORM |
BAG |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
BREAST MILK BAG |
| 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 |
BREAST MILK STORAGE BAG |
| VA PRODUCT IDENTIFIER |
XI538 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
BAG |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035700 |
| EFFECTIVE DATE/TIME |
-
- 2016-05-13 00:00:00
- STATUS: ACTIVE
|
