BANDAGE,ELASTIC SWIFT WRAP 2IN X 5YD (28824)    VA PRODUCT (50.68)

Name Value
NAME BANDAGE,ELASTIC SWIFT WRAP 2IN X 5YD
VA GENERIC NAME BANDAGE,GAUZE ELASTIC
DOSAGE FORM BANDAGE
NATIONAL FORMULARY NAME BANDAGE,GAUZE ELASTIC BANDAGE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-10-04 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BANDAGE,ELASTIC SWIFT WRAP 2IN X 5YD
VA PRODUCT IDENTIFIER XJ474
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4037890
EFFECTIVE DATE/TIME
  • 2018-10-05 00:00:00
    STATUS:   ACTIVE