DRESSING,MEXTRA SUPERABSORBANT 5IN X 5IN #610000 (29703)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,MEXTRA SUPERABSORBANT 5IN X 5IN #610000
VA GENERIC NAME DRESSING,MEXTRA
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DRESSING,MEXTRA DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2019-11-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,MEXTRA 5IN X 5IN #610000
VA PRODUCT IDENTIFIER XJ865
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4038887
EFFECTIVE DATE/TIME
  • 2019-11-05 00:00:00
    STATUS:   ACTIVE