GAUZE ADAPTIC 5IN X 9IN (14553)    VA PRODUCT (50.68)

Name Value
NAME GAUZE ADAPTIC 5IN X 9IN
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 5IN X 9IN
VA PRODUCT IDENTIFIER XY861
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4014917
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE