| NAME |
DIALYSATE,NXSTAGE PUREFLOW #RFP-406 SOLN |
| VA GENERIC NAME |
PUREFLOW |
| DOSAGE FORM |
SOLN,DIALYSIS |
| NATIONAL FORMULARY NAME |
PUREFLOW SOLN,DIALYSIS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2018-03-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DIALYSATE,NXSTAGE PUREFLOW #RFP-406 SOLN |
| VA PRODUCT IDENTIFIER |
D1178 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
BAG |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037238 |
| EFFECTIVE DATE/TIME |
-
- 2018-01-22 00:00:00
- STATUS: ACTIVE
|
