| NAME |
ALLERGENIC EXTRACT,GRASTEK 2800UNIT TAB,SL |
| VA GENERIC NAME |
ALLERGENIC EXTRACT |
| DOSAGE FORM |
TAB,SUBLINGUAL |
| FDA MED GUIDE |
Allergen_Extract_Timothy_Pollen_(Grastek)_(2015).pdf |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
ALLERGENIC EXTRACT TAB,SUBLINGUAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| 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 |
ALLERGENIC EXTR,GRASTEK 2800UNIT SL TAB |
| VA PRODUCT IDENTIFIER |
A1779 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TAB |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4034008 |
| EFFECTIVE DATE/TIME |
-
- 2014-12-30 00:00:00
- STATUS: ACTIVE
|
