DRESSING,CICA-CARE 2.36IN X 4.72IN SN#6272 (14337)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,CICA-CARE 2.36IN X 4.72IN SN#6272
VA GENERIC NAME DRESSING,CICA-CARE
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,CICA-CARE 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,CICA-CARE 2.36INX4.72IN SN#6272
VA PRODUCT IDENTIFIER XY189
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014701
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE