PREVAIL BELTED UNDERGARMENT PV-324 (31376)    VA PRODUCT (50.68)

Name Value
NAME PREVAIL BELTED UNDERGARMENT PV-324
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:   2021-08-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PREVAIL BELTED UNDERGARMENT PV-324
VA PRODUCT IDENTIFIER XK830
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040760
EFFECTIVE DATE/TIME
  • 2021-08-25 00:00:00
    STATUS:   ACTIVE
  • 2021-08-25 00:00:00
    STATUS:   ACTIVE