DRESSING,HYDROFERA BLUE 4IN X 5IN HBRS4520 (25977)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,HYDROFERA BLUE 4IN X 5IN HBRS4520
VA GENERIC NAME DRESSING,HYDROFERA
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,HYDROFERA 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,HYDROFERA BLUE 4INX5IN HBRS4520
VA PRODUCT IDENTIFIER XI163
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4034752
EFFECTIVE DATE/TIME
  • 2015-08-21 00:00:00
    STATUS:   ACTIVE