CLEANSER,RESTORE H#517210 (22105)    VA PRODUCT (50.68)

Name Value
NAME CLEANSER,RESTORE H#517210
VA GENERIC NAME CLEANSER
DOSAGE FORM LIQUID,TOP
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2019-09-16 00:00:00
NATIONAL FORMULARY NAME CLEANSER LIQUID,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
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 CLEANSER,RESTORE H#517210
VA PRODUCT IDENTIFIER XT793
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4030354
EFFECTIVE DATE/TIME
  • 2011-01-11 00:00:00
    STATUS:   ACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE
  • 2019-09-16 00:00:00
    STATUS:   INACTIVE