| NAME |
FIBRINOGEN/THROMBIN 4IN X 4IN PATCH,TOP |
| VA GENERIC NAME |
FIBRINOGEN/THROMBIN |
| DOSAGE FORM |
PAD,TOP |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
FIBRINOGEN/THROMBIN PAD,TOP |
| 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 |
FIBRINOGEN/THROMBIN 4IN X 4IN TOP PATCH |
| VA PRODUCT IDENTIFIER |
F0580 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034872 |
| EFFECTIVE DATE/TIME |
-
- 2015-10-06 00:00:00
- STATUS: ACTIVE
|
