PHISODERM SOAP (9251) VA PRODUCT (50.68)

Name	Value
NAME	PHISODERM SOAP
VA GENERIC NAME	PHISODERM
DOSAGE FORM	SOAP/DETERGENT
ACTIVE INGREDIENTS	MINERAL OIL PETROLATUM,WHITE LANOLIN ALCOHOL OCTOXYNOL 2 ETHANESULFONATE SODIUM OCTOXYNOL 3 TETRASODIUM EDTA OLEYL ALCOHOL SODIUM BENZOATE METHYLCELLULOSE HYDROCHLORIC ACID
CS FEDERAL SCHEDULE	Unscheduled
DSS NUMBER	1
NATIONAL FORMULARY NAME	PHISODERM SOAP/DETERGENT
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	PHISODERM SOAP
VA PRODUCT IDENTIFIER	P1310
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4009680
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE