DRESSING,TEGADERM CHG IV 3.5IN X 4.5IN W/DEVICE (31643)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,TEGADERM CHG IV 3.5IN X 4.5IN W/DEVICE
VA GENERIC NAME DRESSING,TEGADERM CHG
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING,TEGADERM CHG DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-12-22 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESS,TEGADERM CHG IV 3.5X4.5IN W/DEVICE
VA PRODUCT IDENTIFIER XL011
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041055
EFFECTIVE DATE/TIME
  • 2021-12-22 00:00:00
    STATUS:   ACTIVE