| NAME |
SALIVA,ARTIFICIAL (SALIVAMAX) 351MG/PKT PWDR |
| VA GENERIC NAME |
SALIVA,ARTIFICIAL |
| DOSAGE FORM |
PWDR,RENST-ORAL |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
SALIVA,ARTIFICIAL PWDR,RENST-ORAL |
| 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 |
ARTIFICIAL SALIVA (SALIVAMAX) 351MG/PKT |
| VA PRODUCT IDENTIFIER |
A1867 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035356 |
| EFFECTIVE DATE/TIME |
-
- 2016-02-04 00:00:00
- STATUS: ACTIVE
|
