BANDAGE TUBULAR ELASTIC 4 1/2IN X 11YD SAG13116 (30648)    VA PRODUCT (50.68)

Name Value
NAME BANDAGE TUBULAR ELASTIC 4 1/2IN X 11YD SAG13116
VA GENERIC NAME BANDAGE TUBULAR
DOSAGE FORM BANDAGE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME BANDAGE TUBULAR BANDAGE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-01-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BANDAGE TUBULAR ELAST 4.5INX11Y SAG13116
VA PRODUCT IDENTIFIER XK341
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ROLL
MASTER ENTRY FOR VUID YES
VUID 4039962
EFFECTIVE DATE/TIME
  • 2021-01-20 00:00:00
    STATUS:   ACTIVE
  • 2021-01-20 00:00:00
    STATUS:   ACTIVE
  • 2021-01-20 00:00:00
    STATUS:   ACTIVE