GELATIN,ABSORBABLE SPONGE,DENTAL SIZE 4 (8134)    VA PRODUCT (50.68)

Name Value
NAME GELATIN,ABSORBABLE SPONGE,DENTAL SIZE 4
VA GENERIC NAME GELATIN,ABSORBABLE
DOSAGE FORM SPONGE
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2021-08-16 00:00:00
DSS NUMBER 4
NATIONAL FORMULARY NAME GELATIN,ABSORBABLE SPONGE
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME GELATIN,ABSORBABLE SPONGE,DENTAL SIZE 4
VA PRODUCT IDENTIFIER G0502
TRANSMIT TO CMOP NO
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4008608
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2021-08-16 00:00:00
    STATUS:   INACTIVE
  • 2021-08-16 00:00:00
    STATUS:   INACTIVE
  • 2021-08-16 00:00:00
    STATUS:   INACTIVE