| NAME |
BANDAGE,ELASTIC MATRIX 4IN X 5YD,LF,STERILE |
| VA GENERIC NAME |
BANDAGE,GAUZE ELASTIC |
| DOSAGE FORM |
BANDAGE |
| NATIONAL FORMULARY NAME |
BANDAGE,GAUZE ELASTIC BANDAGE |
| 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 |
BANDAGE,ELAST MATRIX 4INX5YD LF STERILE |
| VA PRODUCT IDENTIFIER |
XI512 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035645 |
| EFFECTIVE DATE/TIME |
-
- 2016-04-25 00:00:00
- STATUS: ACTIVE
|
