ADHESIVE FOAM STRIP UROFOAM-2 (27159)    VA PRODUCT (50.68)

Name Value
NAME ADHESIVE FOAM STRIP UROFOAM-2
VA GENERIC NAME STRIP
DOSAGE FORM STRIP
NATIONAL FORMULARY NAME STRIP STRIP
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 ADHESIVE FOAM STRIP UROFOAM-2
VA PRODUCT IDENTIFIER XI670
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036041
EFFECTIVE DATE/TIME
  • 2016-09-20 00:00:00
    STATUS:   ACTIVE