BIOTENE SENSITIVE TOOTHPASTE (18600)    VA PRODUCT (50.68)

Name Value
NAME BIOTENE SENSITIVE TOOTHPASTE
VA GENERIC NAME BIOTENE
DOSAGE FORM TOOTHPASTE
FORMULARY DESIGNATOR TEXT
Not provided by pharmacy for inpatient use.
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME BIOTENE TOOTHPASTE
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 SENSITIVE TOOTHPASTE
VA PRODUCT IDENTIFIER B0578
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4026400
EFFECTIVE DATE/TIME
  • 2007-08-30 00:00:00
    STATUS:   ACTIVE