FIBRINOGEN/THROMBIN 3.7IN X 1.9IN PATCH,TOP (28285)    VA PRODUCT (50.68)

Name Value
NAME FIBRINOGEN/THROMBIN 3.7IN X 1.9IN PATCH,TOP
VA GENERIC NAME FIBRINOGEN/THROMBIN
DOSAGE FORM PAD,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME FIBRINOGEN/THROMBIN PAD,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-03-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FIBRINOGEN/THROMBIN 3.7X1.9IN TOP PATCH
VA PRODUCT IDENTIFIER F0643
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037275
EFFECTIVE DATE/TIME
  • 2018-02-05 00:00:00
    STATUS:   ACTIVE