KALTOSTAT FORTEX CA/NA ALGINATE DRESSING (12021)    VA PRODUCT (50.68)

Name Value
NAME KALTOSTAT FORTEX CA/NA ALGINATE DRESSING
VA GENERIC NAME CALCIUM/SODIUM ALGINATE
DOSAGE FORM DRESSING
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 1
NATIONAL FORMULARY NAME CALCIUM/SODIUM ALGINATE DRESSING
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 KALTOSTAT FORTEX CA/NA ALGINATE DRESSING
VA PRODUCT IDENTIFIER XK002
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4012387
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE