| NAME |
DRESSING,OPTIFOAM GENTLE EX SACRUM 9IN X 9IN #MSCEX99EP |
| VA GENERIC NAME |
DRESSING,OPTIFOAM |
| DOSAGE FORM |
DRESSING,TOP |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
DRESSING,OPTIFOAM DRESSING,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2022-09-08 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DRESS,OPTIFM GNTL EX SACRM 9X9IN MSCEX99 |
| VA PRODUCT IDENTIFIER |
XL314 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041685 |
| EFFECTIVE DATE/TIME |
-
- 2022-09-09 00:00:00
- STATUS: ACTIVE
|
