BARRIER,STOMAHESIVE W/FLANGE C#4116-32 (30867)    VA PRODUCT (50.68)

Name Value
NAME BARRIER,STOMAHESIVE W/FLANGE C#4116-32
VA GENERIC NAME STOMAHESIVE WAFER
DOSAGE FORM BARRIER
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME STOMAHESIVE WAFER BARRIER
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-03-11 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BARRIER,STOMAHESIVE W/FLANGE C#4116-32
VA PRODUCT IDENTIFIER XK493
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040206
EFFECTIVE DATE/TIME
  • 2021-03-11 00:00:00
    STATUS:   ACTIVE
  • 2021-03-11 00:00:00
    STATUS:   ACTIVE
  • 2021-03-11 00:00:00
    STATUS:   ACTIVE