| NAME |
ADAPTER,FEEDING,Y-PORT 24FR ADAPTER #M00580651 |
| VA GENERIC NAME |
ADAPTER |
| DOSAGE FORM |
DEVICE |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
ADAPTER DEVICE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2021-12-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ADAPT,FEED,Y-PORT 24F ADAPTER #M00580651 |
| VA PRODUCT IDENTIFIER |
XK963 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4040995 |
| EFFECTIVE DATE/TIME |
-
- 2021-12-01 00:00:00
- STATUS: ACTIVE
|
