INCONT LINER DEPEND SHIELD #35641 (29248)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER DEPEND SHIELD #35641
VA GENERIC NAME PAD
DOSAGE FORM PAD
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME PAD PAD
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2019-05-16 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT LINER DEPEND SHIELD #35641
VA PRODUCT IDENTIFIER XJ634
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4038394
EFFECTIVE DATE/TIME
  • 2019-05-16 00:00:00
    STATUS:   ACTIVE