DRESSING,PROFORE-LITE 3-LAYER SN#66000771 (25975)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,PROFORE-LITE 3-LAYER SN#66000771
VA GENERIC NAME DRESSING,PROFORE
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,PROFORE 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,PROFORE-LITE 3-LAYR SN#66000771
VA PRODUCT IDENTIFIER XI161
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034750
EFFECTIVE DATE/TIME
  • 2015-08-21 00:00:00
    STATUS:   ACTIVE