DRESSING,OPTIFOAM NON-ADHESIVE 4IN X 4IN #MSC1244 (22249)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTIFOAM NON-ADHESIVE 4IN X 4IN #MSC1244
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 NON-ADHES 4X4 MSC1244
VA PRODUCT IDENTIFIER XT876
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030517
EFFECTIVE DATE/TIME
  • 2011-04-08 00:00:00
    STATUS:   ACTIVE