GLUCOSE SENSOR FREESTYLE LIBRE 3 (32259)    VA PRODUCT (50.68)

Name Value
NAME GLUCOSE SENSOR FREESTYLE LIBRE 3
VA GENERIC NAME GLUCOSE SENSOR
DOSAGE FORM MISCELLANEOUS
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME GLUCOSE SENSOR MISCELLANEOUS
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-10-05 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME GLUCOSE SENSOR FREESTYLE LIBRE 3
VA PRODUCT IDENTIFIER XL337
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041734
EFFECTIVE DATE/TIME
  • 2022-10-05 00:00:00
    STATUS:   ACTIVE