| NAME |
GAUZE,PACKING ALGINATE AG 0.5IN X 5YD DEROYAL #46-PG12 |
| 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 |
|
| 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 0.5INX5YD DR#46-PG12 |
| VA PRODUCT IDENTIFIER |
XH928 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034196 |
| EFFECTIVE DATE/TIME |
-
- 2015-02-18 00:00:00
- STATUS: ACTIVE
|
