| NAME |
DRESSING,ALLEVYN LIFE FOAM 6 1/16IN X 6 1/16IN U#66801069 |
| VA GENERIC NAME |
DRESSING |
| DOSAGE FORM |
DRESSING,TOP |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2017-01-10 00:00:00 |
| NATIONAL FORMULARY NAME |
DRESSING DRESSING,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 |
DRESSING,ALLEVYN LIFE 6 1/16 X 6 1/16IN |
| VA PRODUCT IDENTIFIER |
XI282 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035024 |
| EFFECTIVE DATE/TIME |
-
- 2015-11-13 00:00:00
- STATUS: ACTIVE
|
