DRESSING,HYDRASORB 3 1/8IN X 3 5/8IN KEN#1694-NZ (14069)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,HYDRASORB 3 1/8IN X 3 5/8IN KEN#1694-NZ
VA GENERIC NAME DRESSING,HYDRASORB
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,HYDRASORB 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,HYDRASORB 3 1/8X3 5/8IN 1694NZ
VA PRODUCT IDENTIFIER XY043
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014433
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE