GAUZE,PACKING ALGINATE AG 0.25IN X 12IN DEROYAL #46-PG14 (24988)    VA PRODUCT (50.68)

Name Value
NAME GAUZE,PACKING ALGINATE AG 0.25IN X 12IN DEROYAL #46-PG14
VA GENERIC NAME DRESSING,ALGINATE W/SILVER
DOSAGE FORM GAUZE
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2015-02-20 00:00:00
NATIONAL FORMULARY NAME DRESSING,ALGINATE W/SILVER GAUZE
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 GAUZE,PACK ALGIN AG 0.25X12IN DR#46-PG14
VA PRODUCT IDENTIFIER XH725
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033638
EFFECTIVE DATE/TIME
  • 2014-08-28 00:00:00
    STATUS:   ACTIVE