SALIVA,ARTIFICIAL (CAPHOSOL) LIQUID,30,KIT (22956) VA PRODUCT (50.68)

Name	Value
NAME	SALIVA,ARTIFICIAL (CAPHOSOL) LIQUID,30,KIT
VA GENERIC NAME	SALIVA,ARTIFICIAL
DOSAGE FORM	LIQUID
ACTIVE INGREDIENTS	CALCIUM STRENGTH: 0.052 UNITS: % SODIUM CHLORIDE STRENGTH: 0.569 UNITS: % SODIUM PHOSPHATE STRENGTH: 0.009 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	SALIVA,ARTIFICIAL LIQUID
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	ARTIFICIAL SALIVA (CAPHOSOL) LIQ 30 KIT
VA PRODUCT IDENTIFIER	S0688
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	KIT
MASTER ENTRY FOR VUID	YES
VUID	4031340
EFFECTIVE DATE/TIME	2012-04-06 00:00:00 STATUS: ACTIVE