DRESSING,RTD NON-ADHERING 4IN X 4IN X 0.25IN (28598) VA PRODUCT (50.68)

Name	Value
NAME	DRESSING,RTD NON-ADHERING 4IN X 4IN X 0.25IN
VA GENERIC NAME	DRESSING
DOSAGE FORM	DRESSING,TOP
ACTIVE INGREDIENTS	METHYLENE BLUE GENTIAN VIOLET SILVER
NATIONAL FORMULARY NAME	DRESSING DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2018-06-25 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	DRESSING,RTD NON-ADHERING 4X4X0.25IN
VA PRODUCT IDENTIFIER	XJ361
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4037626
EFFECTIVE DATE/TIME	2018-06-27 00:00:00 STATUS: ACTIVE