LUBRICANT,ACTIVALVE PROVOX #7149 (28789)    VA PRODUCT (50.68)

Name Value
NAME LUBRICANT,ACTIVALVE PROVOX #7149
VA GENERIC NAME LUBRICANT
DOSAGE FORM SOLN,TOP
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME LUBRICANT SOLN,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-09-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME LUBRICANT,ACTIVALVE PROVOX #7149
VA PRODUCT IDENTIFIER L0767
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4037855
EFFECTIVE DATE/TIME
  • 2018-09-27 00:00:00
    STATUS:   ACTIVE