DRESSING,ALLEVYN GENTLE BORDER LITE 5.4CM X 12CM #66020410 (25258)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,ALLEVYN GENTLE BORDER LITE 5.4CM X 12CM #66020410
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2022-06-21 00:00:00
NATIONAL FORMULARY NAME DRESSING 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,ALLEV GB LTE 5.4X12CM #66020410
VA PRODUCT IDENTIFIER XH838
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4033951
EFFECTIVE DATE/TIME
  • 2014-12-16 00:00:00
    STATUS:   ACTIVE
  • 2022-06-21 00:00:00
    STATUS:   INACTIVE