| NAME |
DRESSING,TEGADERM,FOAM 4 IN X 4.5 IN 3M#90611 |
| VA GENERIC NAME |
DRESSING,TEGADERM FOAM |
| DOSAGE FORM |
DRESSING,TOP |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
DRESSING,TEGADERM FOAM DRESSING,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-04-20 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
TEGADERM,FOAM 4 X 4.5IN 3M#90611 |
| VA PRODUCT IDENTIFIER |
XL521 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042184 |
| EFFECTIVE DATE/TIME |
-
- 2023-04-20 00:00:00
- STATUS: ACTIVE
|
