EFFERDENT DENTURE CLEANER TAB,EFFERVSC (10190) VA PRODUCT (50.68)

Name	Value
NAME	EFFERDENT DENTURE CLEANER TAB,EFFERVSC
VA GENERIC NAME	EFFERDENT
DOSAGE FORM	TAB,EFFERVSC,TOP
ACTIVE INGREDIENTS	SODIUM CARBONATE MAGNESIUM STEARATE SODIUM LAURYL SULFOACETATE CITRIC ACID SODIUM BICARBONATE
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	EFFERDENT TAB,EFFERVSC,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2017-06-30 00:00:00 COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2017-07-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	EFFERDENT EFFERVSC TAB
VA PRODUCT IDENTIFIER	E0711
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	TAB
MASTER ENTRY FOR VUID	YES
VUID	4010565
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE