| NAME |
ALUMINUM ZIRCONIUM TRICHLOROHYDREX GLYCINE 17.8% STICK,TOP |
| VA GENERIC NAME |
ALUMINUM ZIRCONIUM TRICHLOROHYDREX GLYCINE |
| DOSAGE FORM |
STICK,TOP |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
ALUMINUM ZIRCONIUM TRICHLOROHYDREX GLYCINE STICK,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 |
AL-ZIRCONIUM-TRICH-GLYCINE TOP STICK |
| VA PRODUCT IDENTIFIER |
A1546 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4029925 |
| EFFECTIVE DATE/TIME |
-
- 2010-07-12 00:00:00
- STATUS: ACTIVE
|
