| NAME |
CLEANSING CLOTH,ADULT W/DIMETHICONE |
| VA GENERIC NAME |
CLEANSING CLOTH |
| DOSAGE FORM |
MISCELLANEOUS |
| NATIONAL FORMULARY NAME |
CLEANSING CLOTH MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-12-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CLEANSING CLOTH,ADULT W/DIMETHICONE |
| VA PRODUCT IDENTIFIER |
XJ030 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036944 |
| EFFECTIVE DATE/TIME |
-
- 2017-10-20 00:00:00
- STATUS: ACTIVE
|
