DRESSING,OPTIFOAM AG GENTLE BORDER 4IN X 4IN #MSC9744 (32099)    VA PRODUCT (50.68)

Name Value
NAME DRESSING,OPTIFOAM AG GENTLE BORDER 4IN X 4IN #MSC9744
VA GENERIC NAME DRESSING,OPTIFOAM
DOSAGE FORM DRESSING,TOP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME DRESSING,OPTIFOAM DRESSING,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2022-07-06 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME DRESS,OPTIFOAM AG GNTL BDR 4X4IN MSC9744
VA PRODUCT IDENTIFIER XL263
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4041557
EFFECTIVE DATE/TIME
  • 2022-07-06 00:00:00
    STATUS:   ACTIVE