DRESSING,AQUACEL FOAM 3IN X 3IN #420804 (28175)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,AQUACEL FOAM 3IN X 3IN #420804
VA GENERIC NAME DRESSING,AQUACEL FOAM
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DRESSING,AQUACEL FOAM DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-01-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,AQUACEL FOAM 3IN X 3IN #420804
VA PRODUCT IDENTIFIER XJ149
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037158
EFFECTIVE DATE/TIME
  • 2017-12-08 00:00:00
    STATUS:   ACTIVE