TRIPLE DYE LIQUID,TOP (6378) VA PRODUCT (50.68)

Name	Value
NAME	TRIPLE DYE LIQUID,TOP
VA GENERIC NAME	BRILLIANT GREEN/GENTIAN VIOLET/PROFLAVINE
DOSAGE FORM	LIQUID,TOP
ACTIVE INGREDIENTS	BRILLIANT GREEN STRENGTH: 2.29 UNITS: MG GENTIAN VIOLET STRENGTH: 2.29 UNITS: MG PROFLAVINE SULFATE STRENGTH: 1.14 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	BRILLIANT GREEN/GENTIAN VIOLET/PROFLAVINE LIQUID,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4006898
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE