| NAME |
FORA GTEL (GLUCOSE) TEST STRIP |
| VA GENERIC NAME |
GLUCOSE TEST |
| DOSAGE FORM |
TEST STRIP |
| HAZARDOUS TO DISPOSE |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
GLUCOSE TEST TEST STRIP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2019-04-25 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FORA GTEL (GLUCOSE) TEST STRIP |
| VA PRODUCT IDENTIFIER |
F0679 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038336 |
| EFFECTIVE DATE/TIME |
-
- 2019-04-25 00:00:00
- STATUS: ACTIVE
|
