INCONT BRIEF MOLICARE SUPER ABSORBENCY MEDIUM (31262)    VA PRODUCT (50.68)

Name Value
NAME INCONT BRIEF MOLICARE SUPER ABSORBENCY MEDIUM
VA GENERIC NAME DIAPER
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DIAPER MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-06-30 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT BRIEF MOLICARE SUPER ABSORB MED
VA PRODUCT IDENTIFIER XK759
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040628
EFFECTIVE DATE/TIME
  • 2021-06-30 00:00:00
    STATUS:   ACTIVE
  • 2021-06-30 00:00:00
    STATUS:   ACTIVE
  • 2021-06-30 00:00:00
    STATUS:   ACTIVE
  • 2021-06-30 00:00:00
    STATUS:   ACTIVE