Prescribing at the VA

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Product Identifiers

NDCGTIN-14Product
60009-0189-80860009189805Vibrant Capsules (20)
60009-0189-82860009189829Vibrant Starter Kit (1)

Download VA Referral Form Download VA Ordering Summary

Vendor & Contracting

Vibrant Gastro, Inc.
9600 Great Hills Trail, Suite 150W, Office 133
Austin, TX 78759

FSS Contract # 36F79725D0174  |  UEI GDBXXGNGXH75  |  CAGE 9TXD2

Dispensing Partner: EVERSANA Life Sciences Services  |  Secure e-fax: (866) 847-7049

Submit the required forms

For new patients, enter a Prosthetics consult for the Vibrant Starter Kit (Activation Pod, Adapter, USB cable, 20 capsules).

Complete the VA Referral Form and send it to your VA Pharmacy.

NPPSC: Prosthetics supplies the Starter Kit; Pharmacy dispenses capsules.

Pharmacy review & secure e-fax

VA Pharmacy reviews the referral and e-faxes to EVERSANA Life Sciences Services at (866) 847-7049 for processing.

Payment (handled by Pharmacy)

Purchase Order (PO): Issue PO to Vibrant Gastro, Inc. (not EVERSANA). EVERSANA submits an e-invoice via Tungsten on Vibrant’s behalf.

Credit card: Available upon request; EVERSANA will contact the VA Pharmacy to collect details.

Refills

The specialty pharmacy contacts the VA Pharmacy 3–4 business days before the patient is to receive the next refill to confirm dispensing and payment authorization (PO). If paying by card, EVERSANA reconfirms payment details.

Product fulfillment

Typical shipment: 2–5 business days to the Veteran’s home or the VA Pharmacy (as designated on the referral form).

If delayed, EVERSANA notifies the Pharmacy’s clinical contact 3–4 business days in advance and provides delivery confirmation for direct-to-patient shipments.

For Procurement / Prosthetics

Vibrant is located under Specialty Distribution Medications. If it’s not visible at your station, contact Pharmacy or Prosthetics.

Leading GI Experts Trust Vibrant

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“The data show that this treatment is both effective and well-tolerated by our patients.”

- Darren M. Brenner, MD
Northwestern Medical Group Gastroenterology