INCONT LINER PREVAIL #PV-926 (31645)    VA PRODUCT (50.68)

Name Value
NAME INCONT LINER PREVAIL #PV-926
VA GENERIC NAME PAD
DOSAGE FORM PAD
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME PAD PAD
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-12-23 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INCONT LINER PREVAIL #PV-926
VA PRODUCT IDENTIFIER XL012
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041057
EFFECTIVE DATE/TIME
  • 2021-12-23 00:00:00
    STATUS:   ACTIVE