DRESSING,MEPILEX XT 4IN X 4IN #211100 (27644)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,MEPILEX XT 4IN X 4IN #211100
VA GENERIC NAME DRESSING,MEPILEX
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,MEPILEX DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-06-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,MEPILEX XT 4IN X 4IN #211100
VA PRODUCT IDENTIFIER XI918
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036578
EFFECTIVE DATE/TIME
  • 2017-04-14 00:00:00
    STATUS:   ACTIVE