DRESSING,AFM ULTRA 3IN X 3IN (31780)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,AFM ULTRA 3IN X 3IN
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
NATIONAL FORMULARY NAME DRESSING DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-03-03 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESSING,AFM ULTRA 3IN X 3IN
VA PRODUCT IDENTIFIER XL086
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041215
EFFECTIVE DATE/TIME
  • 2022-03-04 00:00:00
    STATUS:   ACTIVE