MICONAZOLE 1200MG INSERT/MICONAZOLE 2% CREAM PACK (25801) VA PRODUCT (50.68)

Name	Value
NAME	MICONAZOLE 1200MG INSERT/MICONAZOLE 2% CREAM PACK
VA GENERIC NAME	MICONAZOLE
DOSAGE FORM	INSERT/CREAM,VAG
ACTIVE INGREDIENTS	MICONAZOLE NITRATE STRENGTH: 1200 UNITS: MG MICONAZOLE STRENGTH: 2 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	MICONAZOLE INSERT/CREAM,VAG
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	MICONAZOLE 1200MG INSRT/MICON 2% CRM VAG
VA PRODUCT IDENTIFIER	M1065
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	PKG
MASTER ENTRY FOR VUID	YES
VUID	4034556
EFFECTIVE DATE/TIME	2015-06-26 00:00:00 STATUS: ACTIVE