STOPPER,STOMA 12FR MTG#ACE12 (32173)    VA PRODUCT (50.68)

Name Value
NAME STOPPER,STOMA 12FR MTG#ACE12
VA GENERIC NAME SUPPLY
DOSAGE FORM DEVICE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME SUPPLY DEVICE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-08-09 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME STOPPER,STOMA 12FR MTG#ACE12
VA PRODUCT IDENTIFIER XL298
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041636
EFFECTIVE DATE/TIME
  • 2022-08-10 00:00:00
    STATUS:   ACTIVE