INCONT BRIEF MOLICARE SUPER ABSORBENCY LARGE (27481)    VA PRODUCT (50.68)

Name Value
NAME INCONT BRIEF MOLICARE SUPER ABSORBENCY LARGE
VA GENERIC NAME DIAPER
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME DIAPER MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-04-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT BRIEF MOLICARE SUPER ABSORB LARGE
VA PRODUCT IDENTIFIER XI846
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036394
EFFECTIVE DATE/TIME
  • 2017-02-07 00:00:00
    STATUS:   ACTIVE