| NAME |
DRESSING,RESTORE,FOAM W/SILICONE 5IN X 6.2IN |
| VA GENERIC NAME |
DRESSING,RESTORE FOAM |
| DOSAGE FORM |
DRESSING,TOP |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
DRESSING,RESTORE FOAM DRESSING,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2018-06-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DRESS,RESTORE,FOAM W/SILICONE 5X6.2IN |
| VA PRODUCT IDENTIFIER |
XJ305 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037504 |
| EFFECTIVE DATE/TIME |
-
- 2018-05-03 00:00:00
- STATUS: ACTIVE
|
