DRESSING,SORBAVIEW 3.75IN X 5IN #SV40XT (24643)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,SORBAVIEW 3.75IN X 5IN #SV40XT
VA GENERIC NAME DRESSING,SORBAVIEW
DOSAGE FORM DRESSING,TOP
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME DRESSING,SORBAVIEW 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,SORBAVIEW 3.75IN X 5IN #SV40XT
VA PRODUCT IDENTIFIER XH584
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033247
EFFECTIVE DATE/TIME
  • 2014-04-23 00:00:00
    STATUS:   ACTIVE