VAD DRIVELINE MAINTENANCE KIT CENTURION #DM395A (31066)    VA PRODUCT (50.68)

Name Value
NAME VAD DRIVELINE MAINTENANCE KIT CENTURION #DM395A
VA GENERIC NAME DRESSING,VENTRICULAR ASSIST DEVICE
DOSAGE FORM KIT
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DRESSING,VENTRICULAR ASSIST DEVICE KIT
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-04-30 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME VAD DRIVELINE MAINT KIT CM #DM395A
VA PRODUCT IDENTIFIER XK637
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4040410
EFFECTIVE DATE/TIME
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE
  • 2021-04-30 00:00:00
    STATUS:   ACTIVE