PICC LINE COVER (31419)    VA PRODUCT (50.68)

Name Value
NAME PICC LINE COVER
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:   2021-09-15 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PICC LINE COVER
VA PRODUCT IDENTIFIER XK863
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4040806
EFFECTIVE DATE/TIME
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE
  • 2021-09-16 00:00:00
    STATUS:   ACTIVE