ADHESIVE,SKIN TAC LIQUID (28013)    VA PRODUCT (50.68)

Name Value
NAME ADHESIVE,SKIN TAC LIQUID
VA GENERIC NAME ADHESIVE,MEDICAL
DOSAGE FORM LIQUID,TOP
NATIONAL FORMULARY NAME ADHESIVE,MEDICAL LIQUID,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-12-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ADHESIVE,SKIN TAC LIQUID
VA PRODUCT IDENTIFIER XJ079
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4037000
EFFECTIVE DATE/TIME
  • 2017-10-30 00:00:00
    STATUS:   ACTIVE