| NAME |
GAUZE,PETROLATUM XEROFORM 5IN X 9IN MEDLINE #253590 |
| VA GENERIC NAME |
GAUZE,PETROLATUM |
| DOSAGE FORM |
GAUZE |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2016-09-26 00:00:00 |
| NATIONAL FORMULARY NAME |
GAUZE,PETROLATUM GAUZE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| 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,PETROLATUM XEROFORM 5X9IN M#253590 |
| VA PRODUCT IDENTIFIER |
XH733 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033676 |
| EFFECTIVE DATE/TIME |
-
- 2014-09-15 00:00:00
- STATUS: ACTIVE
|
