| NAME |
SALIVA,ARTIFICIAL (ORAL BALANCE) GEL,DENT |
| VA GENERIC NAME |
ARTIFICIAL SALIVA |
| DOSAGE FORM |
GEL,DENT |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
ARTIFICIAL SALIVA GEL,DENT |
| 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 |
ARTIFICIAL SALIVA ORAL BALANCE DENT GEL |
| VA PRODUCT IDENTIFIER |
S0666 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TUBE |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4030793 |
| EFFECTIVE DATE/TIME |
-
- 2011-07-12 00:00:00
- STATUS: ACTIVE
|
