GAUZE ADAPTIC ROLL 3IN X 60IN (14552)    VA PRODUCT (50.68)

Name Value
NAME GAUZE ADAPTIC ROLL 3IN X 60IN
VA GENERIC NAME GAUZE,OIL EMULSION
DOSAGE FORM GAUZE
NATIONAL FORMULARY NAME GAUZE,OIL EMULSION GAUZE
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 GAUZE ADAPTIC ROLL 3IN X 60IN
VA PRODUCT IDENTIFIER XY860
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014916
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE