DRESSING,GEL FIBER SILVER 4IN X 4.75IN MC#177400 (32968) VA PRODUCT (50.68)
Name
Value
NAME
DRESSING,GEL FIBER SILVER 4IN X 4.75IN MC#177400
ACTIVE INGREDIENTS
COPAY TIER
PGX ELIGIBLE
NO
PGX SUPPRESSED
NO
EFFECTIVE DATE/TIME
