SPONGE,DRAIN 2IN X 2IN SORB-IT KEN#6241 (26621)    VA PRODUCT (50.68)

Name Value
NAME SPONGE,DRAIN 2IN X 2IN SORB-IT KEN#6241
VA GENERIC NAME DRAIN
DOSAGE FORM SPONGE
NATIONAL FORMULARY NAME DRAIN SPONGE
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 SPONGE,DRAIN 2IN X 2IN SORB-IT KEN#6241
VA PRODUCT IDENTIFIER XI423
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4035456
EFFECTIVE DATE/TIME
  • 2016-03-02 00:00:00
    STATUS:   ACTIVE