CLEANSER,PROSTHETIC ALPS #PD595 (30766)    VA PRODUCT (50.68)

Name Value
NAME CLEANSER,PROSTHETIC ALPS #PD595
VA GENERIC NAME CLEANSER
DOSAGE FORM LIQUID,TOP
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
NATIONAL FORMULARY NAME CLEANSER LIQUID,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2021-02-24 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CLEANSER,PROSTHETIC ALPS #PD595
VA PRODUCT IDENTIFIER XK414
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4040096
EFFECTIVE DATE/TIME
  • 2021-02-24 00:00:00
    STATUS:   ACTIVE
  • 2021-02-24 00:00:00
    STATUS:   ACTIVE
  • 2021-02-24 00:00:00
    STATUS:   ACTIVE