DRESSING,RESTORE TAPERED TRIANGLE 17IN H#519959 (18891)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,RESTORE TAPERED TRIANGLE 17IN H#519959
VA GENERIC NAME DRESSING,RESTORE
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,RESTORE 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,RESTORE TAPER 17IN H#519959
VA PRODUCT IDENTIFIER XV635
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4026718
EFFECTIVE DATE/TIME
  • 2007-11-14 00:00:00
    STATUS:   ACTIVE