DRESSING,TEGADERM CLEAR ABSORBENT ACRYLIC 3IN X 3.75IN (23065)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,TEGADERM CLEAR ABSORBENT ACRYLIC 3IN X 3.75IN
VA GENERIC NAME DRESSING,TEGADERM CLEAR ACRYLIC
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,TEGADERM CLEAR ACRYLIC DRESSING
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 ABS CLEAR ACRYLIC 3X3.75IN
VA PRODUCT IDENTIFIER XR310
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4031457
EFFECTIVE DATE/TIME
  • 2012-06-11 00:00:00
    STATUS:   ACTIVE