FERRIC SUBSULFATE AQUEOUS 8GM/VIL GEL,TOP (18703) VA PRODUCT (50.68)

Name	Value
NAME	FERRIC SUBSULFATE AQUEOUS 8GM/VIL GEL,TOP
VA GENERIC NAME	FERRIC SUBSULFATE
DOSAGE FORM	GEL,TOP
ACTIVE INGREDIENTS	GLYCERIN STRENGTH: 13.3 UNITS: % FERRIC SUBSULFATE STRENGTH: 259 UNITS: MG/ML POVIDONE STRENGTH: 23.2 UNITS: %
NATIONAL FORMULARY NAME	FERRIC SUBSULFATE GEL,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
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FERRIC SUBSULFATE AQUEOUS 8GM/VI TOP GEL
VA PRODUCT IDENTIFIER	F0398
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	VI
MASTER ENTRY FOR VUID	YES
VUID	4026520
EFFECTIVE DATE/TIME	2007-10-10 00:00:00 STATUS: ACTIVE