DRESSING,OPTICELL AG PLUS 4IN X 5IN MEDLINE #MSC9845EP (26394)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTICELL AG PLUS 4IN X 5IN MEDLINE #MSC9845EP
VA GENERIC NAME DRESSING,OPTICELL
DOSAGE FORM DRESSING,TOP
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING,OPTICELL DRESSING
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 DRESS,OPTICELL AG PLUS 4X5IN #MSC9845EP
VA PRODUCT IDENTIFIER XI317
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035210
EFFECTIVE DATE/TIME
  • 2015-12-14 00:00:00
    STATUS:   ACTIVE