| NAME |
PENTAFLUOROPROPANE/TETRAFLUOROETHANE AEROSOL,TOP,MIST |
| VA GENERIC NAME |
PENTAFLUOROPROPANE/TETRAFLUOROETHANE |
| DOSAGE FORM |
AEROSOL,TOP |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR TEXT |
SPRAY AND STRETCH TOP AEROSOL
|
| 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 |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
PAIN EASE TOP AEROSOL MIST SPRAY |
| VA PRODUCT IDENTIFIER |
P0718 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
CAN |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4024549 |
| EFFECTIVE DATE/TIME |
-
- 2006-01-24 00:00:00
- STATUS: ACTIVE
|
