SULFONATED PHENOL 50%/SULFURIC ACID 30% SWABSTICK,TOP (25572) VA PRODUCT (50.68)

Name	Value
NAME	SULFONATED PHENOL 50%/SULFURIC ACID 30% SWABSTICK,TOP
VA GENERIC NAME	SULFONATED PHENOL/SULFURIC ACID
DOSAGE FORM	STICK,TOP
ACTIVE INGREDIENTS	SULFURIC ACID STRENGTH: 30 UNITS: % SULFONATED PHENOL STRENGTH: 50 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	SULFONATED PHENOL/SULFURIC ACID STICK,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	SULFON PHENOL 50%/SULFURIC 30% SWABSTICK
VA PRODUCT IDENTIFIER	S0763
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4034304
EFFECTIVE DATE/TIME	2015-03-19 00:00:00 STATUS: ACTIVE