DRESSING,ALLEVYN LIFE FOAM 4IN X 4IN U#66801067 (24616)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,ALLEVYN LIFE FOAM 4IN X 4IN U#66801067
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
CS FEDERAL SCHEDULE Unscheduled
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 LIFE 4X4IN U#66801067
VA PRODUCT IDENTIFIER XH568
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033215
EFFECTIVE DATE/TIME
  • 2014-04-10 00:00:00
    STATUS:   ACTIVE
  • 2019-06-04 00:00:00
    STATUS:   ACTIVE