DRESSING,LYOFOAM MAX T 3.5IN X 3.5IN SC#603207 (25241)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,LYOFOAM MAX T 3.5IN X 3.5IN SC#603207
VA GENERIC NAME DRESSING,LYOFOAM
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,LYOFOAM 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,LYOFOAM MAX 3.5X3.5IN SC#603207
VA PRODUCT IDENTIFIER XH823
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033931
EFFECTIVE DATE/TIME
  • 2014-12-16 00:00:00
    STATUS:   ACTIVE