DRESSING,MELGISORB PLUS CALCIUM ALGINATE 4IN X 4IN (28629)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,MELGISORB PLUS CALCIUM ALGINATE 4IN X 4IN
VA GENERIC NAME DRESSING,MELGISORB
DOSAGE FORM DRESSING,TOP
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING,MELGISORB DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-07-12 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESS,MELGISORB PLUS,CA ALGINATE 4X4IN
VA PRODUCT IDENTIFIER XJ374
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037662
EFFECTIVE DATE/TIME
  • 2018-07-13 00:00:00
    STATUS:   ACTIVE