BANISH SUPER LIQUID (15103)    VA PRODUCT (50.68)

Name Value
NAME BANISH SUPER LIQUID
VA GENERIC NAME BANISH
DOSAGE FORM LIQUID,TOP
NATIONAL FORMULARY NAME BANISH LIQUID,TOP
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 BANISH SUPER LIQUID
VA PRODUCT IDENTIFIER B0472
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4015467
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE