KIT PREP OF TECHNETUM TC-99 SESTAMIBI NO.1 INJ (29752)    VA PRODUCT (50.68)

Name Value
NAME KIT PREP OF TECHNETUM TC-99 SESTAMIBI NO.1 INJ
VA GENERIC NAME TECHNETIUM
DOSAGE FORM KIT
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME TECHNETIUM KIT
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2019-11-21 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME KIT PREP OF TECHNETUM TC-99 SESTAMIBI 1
VA PRODUCT IDENTIFIER K0083
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4038953
EFFECTIVE DATE/TIME
  • 2019-11-21 00:00:00
    STATUS:   ACTIVE