HEMORRHOIDAL SUPP,RTL (8304) VA PRODUCT (50.68)

Name	Value
NAME	HEMORRHOIDAL SUPP,RTL
VA GENERIC NAME	HEMORRHOIDAL
DOSAGE FORM	SUPP,RTL
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PERUVIAN BALSAM STRENGTH: 1.8 UNITS: % BISMUTH RESORCIN COMPOUND STRENGTH: 1.75 UNITS: % ZINC OXIDE STRENGTH: 11 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2014-08-19 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	HEMORRHOIDAL SUPP,RTL
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	HEMORRHOIDAL RTL SUPP
VA PRODUCT IDENTIFIER	H0027
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4008772
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE