POVIDONE IODINE 12% DOUCHE,CONC,VAG (7696)    VA PRODUCT (50.68)

Name Value
NAME POVIDONE IODINE 12% DOUCHE,CONC,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 12
INACTIVATION DATE 2002-12-06 00:00:00
UNITS %
DSS NUMBER 27
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 12% VAGINAL DOUCHE CONC
VA PRODUCT IDENTIFIER P0345
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4008191
EFFECTIVE DATE/TIME
  • 2002-12-06 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE