TRACH FILTER FOAM CARDINAL #22039 (28315)    VA PRODUCT (50.68)

Name Value
NAME TRACH FILTER FOAM CARDINAL #22039
VA GENERIC NAME FILTER
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME FILTER MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-04-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME TRACH FILTER FOAM CARDINAL #22039
VA PRODUCT IDENTIFIER XJ218
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037307
EFFECTIVE DATE/TIME
  • 2018-02-14 00:00:00
    STATUS:   ACTIVE