DRESSING,TEGADERM AG MESH 4IN X 5IN #90501 (20403)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,TEGADERM AG MESH 4IN X 5IN #90501
VA GENERIC NAME DRESSING,TEGADERM AG
DOSAGE FORM DRESSING
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING,TEGADERM AG DRESSING
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,TEGADERM AG MESH 4X5IN #90501
VA PRODUCT IDENTIFIER XU717
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4028402
EFFECTIVE DATE/TIME
  • 2009-03-12 00:00:00
    STATUS:   ACTIVE