INCONT LINER BUTTERFLY PATCH S/M (30200)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER BUTTERFLY PATCH S/M
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:   2020-06-16 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT LINER BUTTERFLY PATCH S/M
VA PRODUCT IDENTIFIER XK119
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039460
EFFECTIVE DATE/TIME
  • 2020-06-16 00:00:00
    STATUS:   ACTIVE