DRESSING,OPTIFOAM ADHESIVE 6.1IN X 5.6IN #MSC1065 (22248)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTIFOAM ADHESIVE 6.1IN X 5.6IN #MSC1065
VA GENERIC NAME DRESSING,OPTIFOAM
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,OPTIFOAM 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,OPTIFOAM ADHESIVE 6.1X5.6IN MSC
VA PRODUCT IDENTIFIER XT875
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030516
EFFECTIVE DATE/TIME
  • 2011-04-08 00:00:00
    STATUS:   ACTIVE