DRESSING,OPTIFOAM NON-ADHESIVE 6IN X 6IN #MSC1266 (22250)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTIFOAM NON-ADHESIVE 6IN X 6IN #MSC1266
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 6X6 MSC1266
VA PRODUCT IDENTIFIER XT877
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030518
EFFECTIVE DATE/TIME
  • 2011-04-08 00:00:00
    STATUS:   ACTIVE