DRESSING,HYDROFERA BLUE 2.5IN OSTOMY #HBRF2650 (25110)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,HYDROFERA BLUE 2.5IN OSTOMY #HBRF2650
VA GENERIC NAME DRESSING,HYDROFERA
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,HYDROFERA 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,HYDROFERA BLUE 2.5IN #HBRF2650
VA PRODUCT IDENTIFIER XH762
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033782
EFFECTIVE DATE/TIME
  • 2014-10-21 00:00:00
    STATUS:   ACTIVE