GAUZE,PACKING ALGINATE AG 0.25IN X 5YD DEROYAL #46-PG14 (25472)    VA PRODUCT (50.68)

Name Value
NAME GAUZE,PACKING ALGINATE AG 0.25IN X 5YD DEROYAL #46-PG14
VA GENERIC NAME DRESSING,ALGINATE W/SILVER
DOSAGE FORM GAUZE
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
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,PAC ALGIN AG 0.25INX5YD DR#46-PG14
VA PRODUCT IDENTIFIER XH927
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034195
EFFECTIVE DATE/TIME
  • 2015-02-18 00:00:00
    STATUS:   ACTIVE