WAFER,SURFIT-NAT MOLDABLE C#4134-21 (30400)    VA PRODUCT (50.68)

Name Value
NAME WAFER,SURFIT-NAT MOLDABLE C#4134-21
VA GENERIC NAME DURAHESIVE WAFER
DOSAGE FORM WAFER
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DURAHESIVE WAFER WAFER
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2020-09-09 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME WAFER,SURFIT-NAT MOLDABLE C#4134-21
VA PRODUCT IDENTIFIER XK231
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039689
EFFECTIVE DATE/TIME
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE
  • 2020-09-10 00:00:00
    STATUS:   ACTIVE