POVIDONE IODINE 0.3% DOUCHE,VAG (7684)    VA PRODUCT (50.68)

Name Value
NAME POVIDONE IODINE 0.3% DOUCHE,VAG
VA GENERIC NAME POVIDONE IODINE
DOSAGE FORM DOUCHE
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.3
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS %
DSS NUMBER 14
NATIONAL FORMULARY NAME POVIDONE IODINE DOUCHE
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
VA PRINT NAME POVIDONE IODINE 0.3% VAG DOUCHE
VA PRODUCT IDENTIFIER P0454
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4008179
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE