| NAME |
ESTRADIOL 0.01% CREAM,VAG |
| VA GENERIC NAME |
ESTRADIOL |
| DOSAGE FORM |
CREAM,VAG |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
0.01 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
% |
| DSS NUMBER |
9 |
| NATIONAL FORMULARY NAME |
ESTRADIOL CREAM,VAG |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2018-02-28 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-03-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ESTRADIOL 0.01% VAG CREAM |
| VA PRODUCT IDENTIFIER |
E0139 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4001670 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
