DRESSING,PROMOGRAN PRISMA MATRIX 19.1IN X 19.1IN JJ#9191 (18202)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,PROMOGRAN PRISMA MATRIX 19.1IN X 19.1IN JJ#9191
VA GENERIC NAME PROMOGRAN PRISMA MATRIX
DOSAGE FORM DRESSING,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2009-09-15 00:00:00
NATIONAL FORMULARY NAME PROMOGRAN PRISMA MATRIX 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 PROMOGRAN PRISMA 19.1IN X 19.1IN JJ#9191
VA PRODUCT IDENTIFIER XV240
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4025946
EFFECTIVE DATE/TIME
  • 2007-03-01 00:00:00
    STATUS:   ACTIVE
  • 2009-01-16 00:00:00
    STATUS:   INACTIVE
  • 2009-02-06 00:00:00
    STATUS:   ACTIVE
  • 2009-09-15 00:00:00
    STATUS:   INACTIVE