| NAME |
COMPLEX CU3 INTENSIVE TISSUE REPAIR CREAM,TOP |
| VA GENERIC NAME |
MOISTURIZING CREAM |
| DOSAGE FORM |
CREAM,TOP |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
MOISTURIZING CREAM CREAM,TOP |
| 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 |
COMPLEX CU3 TISSUE REPAIR TOP CREAM |
| VA PRODUCT IDENTIFIER |
C1618 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033327 |
| EFFECTIVE DATE/TIME |
-
- 2014-05-16 00:00:00
- STATUS: ACTIVE
|
