
| Name | Value |
|---|---|
| NAME | DRESSING,SPAND-GEL WOUND GEL,TOP |
| VA GENERIC NAME | DRESSING,SPAND-GEL |
| DOSAGE FORM | GEL,TOP |
| NATIONAL FORMULARY NAME | SPAND-GEL GEL,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | DRESSING,SPAND-GEL WOUND TOP GEL |
| VA PRODUCT IDENTIFIER | XT735 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | GM |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4030200 |
| EFFECTIVE DATE/TIME |
|