DRESSING,OPTILOCK 5IN X 5.5IN #MSC6455 (22253)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTILOCK 5IN X 5.5IN #MSC6455
VA GENERIC NAME DRESSING,OPTILOCK
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,OPTILOCK 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,OPTILOCK 5IN X 5.5IN #MSC6455
VA PRODUCT IDENTIFIER XT879
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030521
EFFECTIVE DATE/TIME
  • 2011-04-08 00:00:00
    STATUS:   ACTIVE