DRESSING,OPTIFOAM GENTLE SACRUM 10IN X 9IN #MSC20109 (28575)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTIFOAM GENTLE SACRUM 10IN X 9IN #MSC20109
VA GENERIC NAME DRESSING,OPTIFOAM
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,OPTIFOAM DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-06-13 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESS,OPTIFO GNTLE SACRM 10X9IN MSC20109
VA PRODUCT IDENTIFIER XJ350
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037601
EFFECTIVE DATE/TIME
  • 2018-06-14 00:00:00
    STATUS:   ACTIVE