POVIDONE IODINE 10% VISCOUS GAUZE PAD,TOP (7702) VA PRODUCT (50.68)

Name	Value
NAME	POVIDONE IODINE 10% VISCOUS GAUZE PAD,TOP
VA GENERIC NAME	POVIDONE IODINE
DOSAGE FORM	PAD
FORMULARY DESIGNATOR TEXT	Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS	PROPYLENE GLYCOL POVIDONE IODINE STRENGTH: 10 UNITS: % PETROLATUM,WHITE WAX POLYETHYLENE GLYCOL
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	10
INACTIVATION DATE	2007-09-25 00:00:00
UNITS	%
DSS NUMBER	33
NATIONAL FORMULARY NAME	POVIDONE IODINE PAD
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 0 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	POVIDONE IODINE 10% VISCOUS GAUZE PAD
VA PRODUCT IDENTIFIER	P0404
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4008197
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-25 00:00:00 STATUS: INACTIVE