SPONGE,DRAIN 4IN X 4IN (27694)    VA PRODUCT (50.68)

Name Value
NAME SPONGE,DRAIN 4IN X 4IN
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:   2017-07-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME SPONGE,DRAIN 4IN X 4IN
VA PRODUCT IDENTIFIER XI946
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036634
EFFECTIVE DATE/TIME
  • 2017-05-09 00:00:00
    STATUS:   ACTIVE