| NAME |
MULTIDEX HYDROPHILIC WOUND GEL,TOP |
| VA GENERIC NAME |
MULTIDEX |
| DOSAGE FORM |
GEL,TOP |
| NATIONAL FORMULARY NAME |
MULTIDEX GEL,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
MALTODEXTRIN WOUND GEL |
| VA PRODUCT IDENTIFIER |
M0951 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4031484 |
| EFFECTIVE DATE/TIME |
-
- 2012-06-11 00:00:00
- STATUS: ACTIVE
|
