WAFER,STOMAHESIVE W/FLANGE C#0256-11 (8163)    VA PRODUCT (50.68)

Name Value
NAME WAFER,STOMAHESIVE W/FLANGE C#0256-11
VA GENERIC NAME STOMAHESIVE WAFER
DOSAGE FORM WAFER
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 1999-06-16 00:00:00
DSS NUMBER 4
NATIONAL FORMULARY NAME STOMAHESIVE WAFER WAFER
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME WAFER,STOMAHESIVE W/FLANGE C#0256-11
VA PRODUCT IDENTIFIER XS613
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4008637
EFFECTIVE DATE/TIME
  • 1999-06-16 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE