WIPE,CPAP MASK CONTOUR #14-965 (31104)    VA PRODUCT (50.68)

Name Value
NAME WIPE,CPAP MASK CONTOUR #14-965
VA GENERIC NAME SUPPLY
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME SUPPLY MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-05-07 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME WIPE,CPAP MASK CONTOUR #14-965
VA PRODUCT IDENTIFIER XK662
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040456
EFFECTIVE DATE/TIME
  • 2021-05-07 00:00:00
    STATUS:   ACTIVE
  • 2021-05-07 00:00:00
    STATUS:   ACTIVE
  • 2021-05-07 00:00:00
    STATUS:   ACTIVE