WAFER,STERILE 4IN X 4IN C#0219-01 (8169)    VA PRODUCT (50.68)

Name Value
NAME WAFER,STERILE 4IN X 4IN C#0219-01
VA GENERIC NAME STOMAHESIVE WAFER
DOSAGE FORM WAFER
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 10
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,STERILE 4IN X 4IN C#0219-01
VA PRODUCT IDENTIFIER XX292
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4008643
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE