| NAME |
DICLOFENAC POTASSIUM 50MG/PKT PWDR,ORAL |
| VA GENERIC NAME |
DICLOFENAC |
| DOSAGE FORM |
POWDER,ORAL |
| FDA MED GUIDE |
Diclofenac_Powder_(Cambia)_(2017).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
50 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
MG/PKT |
| NATIONAL FORMULARY NAME |
DICLOFENAC POWDER,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2022-12-28 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-12-29 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DICLOFENAC POTASSIUM 50MG/PKT ORAL PWDR |
| VA PRODUCT IDENTIFIER |
D0853 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4029994 |
| EFFECTIVE DATE/TIME |
-
- 2010-08-13 00:00:00
- STATUS: ACTIVE
|
