| NAME |
BANDAGE TUBULAR ELASTIC 5 1/2IN X 11YD SAG13121 |
| VA GENERIC NAME |
BANDAGE TUBULAR |
| DOSAGE FORM |
BANDAGE |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
BANDAGE TUBULAR BANDAGE |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-01-30 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BANDAGE TUBULAR ELAST 5.5INX11Y SAG13121 |
| VA PRODUCT IDENTIFIER |
XL448 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ROLL |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041997 |
| EFFECTIVE DATE/TIME |
-
- 2023-01-30 00:00:00
- STATUS: ACTIVE
|
