DRESSING,LYOFOAM EXTRA 4IN X 4IN C#1656-55 (13333)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,LYOFOAM EXTRA 4IN X 4IN C#1656-55
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 4IN X 4IN C#1656-55
VA PRODUCT IDENTIFIER XX736
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4013698
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE