BIOTENE MOUTHWASH (18599)    VA PRODUCT (50.68)

Name Value
NAME BIOTENE MOUTHWASH
VA GENERIC NAME BIOTENE
DOSAGE FORM MOUTHWASH
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR TEXT 
Not provided by pharmacy for inpatient use.
NATIONAL FORMULARY NAME BIOTENE MOUTHWASH
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 BIOTENE MOUTHWASH
VA PRODUCT IDENTIFIER B0577
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4026399
EFFECTIVE DATE/TIME
  • 2007-08-30 00:00:00
    STATUS:   ACTIVE