DRESSING,HYDROFERA BLUE HEAVY DRAINAGE 4IN X 4IN HBHD4450 (22436)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,HYDROFERA BLUE HEAVY DRAINAGE 4IN X 4IN HBHD4450
VA GENERIC NAME DRESSING,HYDROFERA
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,HYDROFERA 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,HYDROFERA BLUE 4 X 4IN HBHD4450
VA PRODUCT IDENTIFIER XR011
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4030714
EFFECTIVE DATE/TIME
  • 2011-06-06 00:00:00
    STATUS:   ACTIVE