
| Name | Value |
|---|---|
| NAME | TAPE,MEPITAC SILICONE 0.75IN X 3YD #298300 |
| VA GENERIC NAME | TAPE |
| DOSAGE FORM | TAPE |
| NATIONAL FORMULARY NAME | TAPE TAPE |
| CREATE DEFAULT POSSIBLE DOSAGE | YES |
| CODING SYSTEM |
|
| COPAY TIER |
|
| PGX ELIGIBLE | NO |
| PGX SUPPRESSED | NO |
| VA PRINT NAME | TAPE,SILICONE MEPITAC 0.75INX3YD #298300 |
| VA PRODUCT IDENTIFIER | T0758 |
| TRANSMIT TO CMOP | NO |
| VA DISPENSE UNIT | EA |
| MASTER ENTRY FOR VUID | YES |
| VUID | 4030406 |
| EFFECTIVE DATE/TIME |
|