BANDAGE,ELASTIC,CONFORMING (MOLLELAST) 1.6IN X 4.4YD (18760)    VA PRODUCT (50.68)

Name Value
NAME BANDAGE,ELASTIC,CONFORMING (MOLLELAST) 1.6IN X 4.4YD
VA GENERIC NAME BANDAGE,STRETCH
DOSAGE FORM BANDAGE
NATIONAL FORMULARY NAME BANDAGE,STRETCH BANDAGE
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 BANDAGE,ELAST (MOLLELAST) 1.6IN X 4.4YD
VA PRODUCT IDENTIFIER XV541
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4026577
EFFECTIVE DATE/TIME
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE