BANDAGE,FOAM COMPRIFOAM 4.7IN X 3YD (30915)    VA PRODUCT (50.68)

Name Value
NAME BANDAGE,FOAM COMPRIFOAM 4.7IN X 3YD
VA GENERIC NAME BANDAGE,FOAM
DOSAGE FORM BANDAGE
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME BANDAGE,FOAM BANDAGE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-03-19 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BANDAGE,FOAM COMPRIFOAM 4.7IN X 3YD
VA PRODUCT IDENTIFIER XK530
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ROLL
MASTER ENTRY FOR VUID YES
VUID 4040249
EFFECTIVE DATE/TIME
  • 2021-03-22 00:00:00
    STATUS:   ACTIVE
  • 2021-03-22 00:00:00
    STATUS:   ACTIVE
  • 2021-03-22 00:00:00
    STATUS:   ACTIVE