BRIEF,TRANQUILITY PREMIUM OVERNIGHT X-SMALL #2113 (30815)    VA PRODUCT (50.68)

Name Value
NAME BRIEF,TRANQUILITY PREMIUM OVERNIGHT X-SMALL #2113
VA GENERIC NAME UNDERPANTS
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME UNDERPANTS MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-03-08 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BRIEF,TRANQUILITY PREM OVERNITE XSM#2113
VA PRODUCT IDENTIFIER XK456
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040149
EFFECTIVE DATE/TIME
  • 2021-03-08 00:00:00
    STATUS:   ACTIVE
  • 2021-03-08 00:00:00
    STATUS:   ACTIVE
  • 2021-03-08 00:00:00
    STATUS:   ACTIVE