VAD DRIVELINE MAINTENANCE KIT CENTURION #DT18655 (31284)    VA PRODUCT (50.68)

Name Value
NAME VAD DRIVELINE MAINTENANCE KIT CENTURION #DT18655
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 YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-07-12 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME VAD DRIVELINE MAINTENANCE KIT CM#DT18655
VA PRODUCT IDENTIFIER XK777
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4040650
EFFECTIVE DATE/TIME
  • 2021-07-13 00:00:00
    STATUS:   ACTIVE
  • 2021-07-13 00:00:00
    STATUS:   ACTIVE
  • 2021-07-13 00:00:00
    STATUS:   ACTIVE