INCONT LINER TRANQUILITY #2380 (28192)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER TRANQUILITY #2380
VA GENERIC NAME PAD
DOSAGE FORM PAD
NATIONAL FORMULARY NAME PAD PAD
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-02-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT LINER TRANQUILITY #2380
VA PRODUCT IDENTIFIER XJ160
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037175
EFFECTIVE DATE/TIME
  • 2017-12-20 00:00:00
    STATUS:   ACTIVE