GAUZE,ELASTIC 3IN F#717-5094 (11207)    VA PRODUCT (50.68)

Name Value
NAME GAUZE,ELASTIC 3IN F#717-5094
VA GENERIC NAME BANDAGE,GAUZE
DOSAGE FORM BANDAGE
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2012-05-10 00:00:00
DSS NUMBER 3
NATIONAL FORMULARY NAME BANDAGE,GAUZE BANDAGE
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 GAUZE,ELASTIC 3IN F#717-5094
VA PRODUCT IDENTIFIER XS648
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ROLL
MASTER ENTRY FOR VUID YES
VUID 4011580
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2012-05-10 00:00:00
    STATUS:   INACTIVE