DRESSING,ALLEVYN AG GENTLE BORDER 5IN X 5IN U#0453 (24547)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,ALLEVYN AG GENTLE BORDER 5IN X 5IN U#0453
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING 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 DRESSING,ALLEVYN AG GNTL BDR 5X5IN #0453
VA PRODUCT IDENTIFIER XH561
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033141
EFFECTIVE DATE/TIME
  • 2014-03-12 00:00:00
    STATUS:   ACTIVE