DRESSING,PROMOGRAN PRISMA MATRIX ROPE #MA032 (30372)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,PROMOGRAN PRISMA MATRIX ROPE #MA032
VA GENERIC NAME PROMOGRAN PRISMA MATRIX
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME PROMOGRAN PRISMA MATRIX DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2020-08-28 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PROMOGRAN PRISMA MATRIX ROPE #MA032
VA PRODUCT IDENTIFIER XK212
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4039660
EFFECTIVE DATE/TIME
  • 2020-08-31 00:00:00
    STATUS:   ACTIVE
  • 2020-08-31 00:00:00
    STATUS:   ACTIVE
  • 2020-08-31 00:00:00
    STATUS:   ACTIVE