DRESSING,COLLAGEN EXTRACELLULAR MATRIX,ANTIMICROB 4X5IN #629314 (31857)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,COLLAGEN EXTRACELLULAR MATRIX,ANTIMICROB 4X5IN #629314
VA GENERIC NAME DRESSING
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-04-04 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESS,COLLAGEN ECM,ANTIMIC 4X5IN #629314
VA PRODUCT IDENTIFIER XL124
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041301
EFFECTIVE DATE/TIME
  • 2022-04-04 00:00:00
    STATUS:   ACTIVE