| NAME |
DRESSING,AQUACEL AG ADVANTAGE SURGICAL 3.5IN X 4IN C#422603 |
| VA GENERIC NAME |
DRESSING,AQUACEL |
| DOSAGE FORM |
DRESSING |
| HAZARDOUS TO DISPOSE |
NO |
| PRIMARY EPA CODE |
D011-SILVER |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
DRESSING,AQUACEL DRESSING |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2022-12-20 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DRESS,AQUACEL AG ADV SUR 3.5X4IN #422603 |
| VA PRODUCT IDENTIFIER |
XL404 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041897 |
| EFFECTIVE DATE/TIME |
-
- 2022-12-21 00:00:00
- STATUS: ACTIVE
|
