GAUZE,PETROLATUM 3IN X 18IN (22877)    VA PRODUCT (50.68)

Name Value
NAME GAUZE,PETROLATUM 3IN X 18IN
VA GENERIC NAME GAUZE,PETROLATUM
DOSAGE FORM GAUZE
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME GAUZE,PETROLATUM GAUZE
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 GAUZE,PETROLATUM 3IN X 18IN
VA PRODUCT IDENTIFIER XR212
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031252
EFFECTIVE DATE/TIME
  • 2012-02-06 00:00:00
    STATUS:   ACTIVE