| NAME |
ORAMAGICRX MOUTHWASH |
| VA GENERIC NAME |
ORAMAGICRX |
| DOSAGE FORM |
SUSP,ORAL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
ORAMAGICRX SUSP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ORAMAGICRX MOUTHWASH |
| VA PRODUCT IDENTIFIER |
O0351 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033541 |
| EFFECTIVE DATE/TIME |
-
- 2014-07-24 00:00:00
- STATUS: ACTIVE
|
