| NAME |
ICODEXTRIN 4% SOLN,IRRG |
| VA GENERIC NAME |
ICODEXTRIN |
| DOSAGE FORM |
SOLN,IRRG |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
4 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
% |
| NATIONAL FORMULARY NAME |
ICODEXTRIN SOLN,IRRG |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ICODEXTRIN 4% IRRG SOLN |
| VA PRODUCT IDENTIFIER |
I0575 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033103 |
| EFFECTIVE DATE/TIME |
-
- 2014-02-24 00:00:00
- STATUS: ACTIVE
|
