| NAME |
DERMARITE 3-N-1 CLEANSING FOAM,TOP |
| VA GENERIC NAME |
CLEANSER |
| DOSAGE FORM |
FOAM,TOP |
| HAZARDOUS TO DISPOSE |
NO |
| NATIONAL FORMULARY NAME |
CLEANSER FOAM,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-01-25 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DERMARITE 3-N-1 CLEANSING TOP FOAM |
| VA PRODUCT IDENTIFIER |
D1305 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4041990 |
| EFFECTIVE DATE/TIME |
-
- 2023-01-26 00:00:00
- STATUS: ACTIVE
|
