RASH RELIEF CLEAR SPRAY,TOP (20769) VA PRODUCT (50.68)

Name	Value
NAME	RASH RELIEF CLEAR SPRAY,TOP
VA GENERIC NAME	DIMETHICONE
DOSAGE FORM	SPRAY,TOP
ACTIVE INGREDIENTS	PETROLATUM STRENGTH: 25 UNITS: % DIMETHICONE STRENGTH: 20 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	RASH RELIEF SPRAY,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	RASH RELIEF CLEAR TOP SPRAY
VA PRODUCT IDENTIFIER	R0264
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4028835
EFFECTIVE DATE/TIME	2009-08-11 00:00:00 STATUS: ACTIVE