| Name | Value |
|---|---|
| NAME | BELT,SUPPORT 4IN MEDIUM NU-HOPE #6311 |
| VA GENERIC NAME | BELT |
| DOSAGE FORM | BELT |
| HAZARDOUS TO DISPOSE | NO |
| NATIONAL FORMULARY NAME | BELT BELT |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | BELT,SUPPORT 4IN MEDIUM NU-HOPE #6311 |
| VA PRODUCT IDENTIFIER | XL526 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4042189 |
| EFFECTIVE DATE/TIME |
|