PENTAFLUOROPROPANE/TETRAFLUOROETHANE AEROSOL,TOP (16860)    VA PRODUCT (50.68)

Name Value
NAME PENTAFLUOROPROPANE/TETRAFLUOROETHANE AEROSOL,TOP
VA GENERIC NAME PENTAFLUOROPROPANE/TETRAFLUOROETHANE
DOSAGE FORM AEROSOL,TOP
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT
SPRAY AND STRETCH TOP AEROSOL. Not provided by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME PENTAFLUOROPROPANE/TETRAFLUOROETHANE AEROSOL,TOP
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 SPRAY AND STRETCH TOP AEROSOL
VA PRODUCT IDENTIFIER P0704
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4017223
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE