| NAME |
HYDROCORTISONE 100MG/60ML ENEMA |
| VA GENERIC NAME |
HYDROCORTISONE |
| DOSAGE FORM |
ENEMA |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
100 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
MG/60ML |
| DSS NUMBER |
26 |
| NATIONAL FORMULARY NAME |
HYDROCORTISONE ENEMA |
| 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 |
HYDROCORTISONE 100MG/60ML ENEMA |
| VA PRODUCT IDENTIFIER |
H0058 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4002915 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
|
