
| Name | Value |
|---|---|
| NAME | ELECTRODE PAD,PROBE AS#PEP |
| VA GENERIC NAME | ELECTRODE |
| DOSAGE FORM | PAD |
| NATIONAL FORMULARY NAME | ELECTRODE PAD |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | ELECTRODE PAD,PROBE AS#PEP |
| VA PRODUCT IDENTIFIER | XJ195 |
| TRANSMIT TO CMOP | YES |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4037255 |
| EFFECTIVE DATE/TIME |
|