| NAME |
CAP,SHAMPOO SAGE #7909 |
| VA GENERIC NAME |
SHAMPOO |
| DOSAGE FORM |
MISCELLANEOUS |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
SHAMPOO MISCELLANEOUS |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
- COPAY END DATE: 2017-06-30 00:00:00
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-07-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
CAP,SHAMPOO SAGE #7909 |
| VA PRODUCT IDENTIFIER |
C1530 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4031835 |
| EFFECTIVE DATE/TIME |
-
- 2012-12-18 00:00:00
- STATUS: ACTIVE
|
