DRESSING,VERSIVA XC 18.5CM X 20.5CM C#410612 (20136)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,VERSIVA XC 18.5CM X 20.5CM C#410612
VA GENERIC NAME DRESSING,VERSIVA XC
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,VERSIVA XC 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,VERSIVA XC 18.5X20.5CM C#410612
VA PRODUCT IDENTIFIER XU523
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4028089
EFFECTIVE DATE/TIME
  • 2008-12-10 00:00:00
    STATUS:   ACTIVE