ELECTRODE SPRAY,ELECTRO MIST (27352)    VA PRODUCT (50.68)

Name Value
NAME ELECTRODE SPRAY,ELECTRO MIST
VA GENERIC NAME SUPPLY
DOSAGE FORM SPRAY,TOP
NATIONAL FORMULARY NAME SUPPLY SPRAY,TOP
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 ELECTRODE SPRAY,ELECTRO MIST
VA PRODUCT IDENTIFIER XI777
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4036253
EFFECTIVE DATE/TIME
  • 2016-12-14 00:00:00
    STATUS:   ACTIVE