| NAME |
BANDAGE,ELASTIC 6IN X 5YD,SELF-ADHERING |
| VA GENERIC NAME |
BANDAGE |
| DOSAGE FORM |
MISCELLANEOUS |
| HAZARDOUS TO DISPOSE |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
BANDAGE MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-05-09 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BANDAGE,ELASTIC 6IN X 5YD,SELF-ADHERING |
| VA PRODUCT IDENTIFIER |
XL542 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
ROLL |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042222 |
| EFFECTIVE DATE/TIME |
-
- 2023-05-09 00:00:00
- STATUS: ACTIVE
|
