DRESSING,TEGADERM,FOAM 5-5/8IN X 5-5/8IN 3M#90612 (22811)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,TEGADERM,FOAM 5-5/8IN X 5-5/8IN 3M#90612
VA GENERIC NAME DRESSING,TEGADERM FOAM
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,TEGADERM FOAM 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 TEGADERM,FOAM 5-5/8 X 5-5/8IN 3M#90612
VA PRODUCT IDENTIFIER XR182
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031169
EFFECTIVE DATE/TIME
  • 2011-12-09 00:00:00
    STATUS:   ACTIVE