LUBRICANT,ALPS PROSTHETIC SOLN,TOP (28750) VA PRODUCT (50.68)

Name	Value
NAME	LUBRICANT,ALPS PROSTHETIC SOLN,TOP
VA GENERIC NAME	LUBRICANT
DOSAGE FORM	SOLN,TOP
ACTIVE INGREDIENTS	ISOPROPYL ALCOHOL STRENGTH: 70 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	LUBRICANT SOLN,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2018-09-10 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	LUBRICANT,ALPS PROSTHETIC TOP SOLN
VA PRODUCT IDENTIFIER	L0764
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4037808
EFFECTIVE DATE/TIME	2018-09-11 00:00:00 STATUS: ACTIVE