GLUCOSE SENSOR (3) GUARDIAN MMT-7020A (28747)    VA PRODUCT (50.68)

Name Value
NAME GLUCOSE SENSOR (3) GUARDIAN MMT-7020A
VA GENERIC NAME GLUCOSE SENSOR
DOSAGE FORM MISCELLANEOUS
NATIONAL FORMULARY NAME GLUCOSE SENSOR MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-09-07 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME GLUCOSE SENSOR (3) GUARDIAN MMT-7020A
VA PRODUCT IDENTIFIER XJ430
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037805
EFFECTIVE DATE/TIME
  • 2018-09-07 00:00:00
    STATUS:   ACTIVE