| NAME |
DRESSING,TEGADERM,FOAM 4IN X 24IN 3M#90605 |
| VA GENERIC NAME |
DRESSING,TEGADERM FOAM |
| DOSAGE FORM |
DRESSING,TOP |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2022-10-17 00:00:00 |
| NATIONAL FORMULARY NAME |
DRESSING,TEGADERM FOAM DRESSING,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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,FOAM 4 X 24IN 3M#90605 |
| VA PRODUCT IDENTIFIER |
XR298 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ROLL |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4031435 |
| EFFECTIVE DATE/TIME |
-
- 2012-05-07 00:00:00
- STATUS: ACTIVE
-
- 2022-10-17 00:00:00
- STATUS: INACTIVE
|
