ULTRASOUND COUPLING PATCH (28129)    VA PRODUCT (50.68)

Name Value
NAME ULTRASOUND COUPLING PATCH
VA GENERIC NAME ULTRASOUND
DOSAGE FORM PATCH
NATIONAL FORMULARY NAME ULTRASOUND PATCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-01-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ULTRASOUND COUPLING PATCH
VA PRODUCT IDENTIFIER XJ136
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037101
EFFECTIVE DATE/TIME
  • 2017-11-24 00:00:00
    STATUS:   ACTIVE