KERLIX 3.4IN STERILE (21397)    VA PRODUCT (50.68)

Name Value
NAME KERLIX 3.4IN STERILE
VA GENERIC NAME BANDAGE,GAUZE
DOSAGE FORM BANDAGE
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME BANDAGE,GAUZE 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 KERLIX 3.4IN STERILE
VA PRODUCT IDENTIFIER XT374
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4029540
EFFECTIVE DATE/TIME
  • 2010-01-12 00:00:00
    STATUS:   ACTIVE