
| Name | Value |
|---|---|
| NAME | STOMA CAP,AMPATCH SG3 |
| VA GENERIC NAME | STOMA CAP |
| DOSAGE FORM | STOMA CAP |
| NATIONAL FORMULARY NAME | STOMA CAP STOMA CAP |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | STOMA CAP,AMPATCH SG3 |
| VA PRODUCT IDENTIFIER | XI689 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4036090 |
| EFFECTIVE DATE/TIME |
|