DRESSING,AQUACEL FOAM 9.5IN X 8.5IN #420828 (29779)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,AQUACEL FOAM 9.5IN X 8.5IN #420828
VA GENERIC NAME DRESSING,AQUACEL FOAM
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
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:   2019-12-04 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,AQUACEL FOAM 9.5X8.5IN #420828
VA PRODUCT IDENTIFIER XJ904
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4038983
EFFECTIVE DATE/TIME
  • 2019-12-05 00:00:00
    STATUS:   ACTIVE