DRESSING,LYOFOAM EXTRA 10IN X 12IN C#1656-70 (13331)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,LYOFOAM EXTRA 10IN X 12IN C#1656-70
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING DRESSING,TOP
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 DRESSING,LYOFOAM EX 10INX12IN C#1656-70
VA PRODUCT IDENTIFIER XX734
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4013696
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE