DRESSING,AFM ULTRA 4IN X 5IN (22428)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,AFM ULTRA 4IN X 5IN
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING 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,AFM ULTRA 4IN X 5IN
VA PRODUCT IDENTIFIER XT998
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030706
EFFECTIVE DATE/TIME
  • 2011-06-06 00:00:00
    STATUS:   ACTIVE