DRESSING,AQUACEL FOAM 4IN X 12IN #421155 (28752)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,AQUACEL FOAM 4IN X 12IN #421155
VA GENERIC NAME DRESSING,AQUACEL FOAM
DOSAGE FORM DRESSING,TOP
NATIONAL FORMULARY NAME DRESSING,AQUACEL FOAM DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-09-12 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,AQUACEL FOAM 4IN X 12IN #421155
VA PRODUCT IDENTIFIER XJ433
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037809
EFFECTIVE DATE/TIME
  • 2018-09-12 00:00:00
    STATUS:   ACTIVE