HYDROGEN PEROXIDE 1.7% GEL,DENTAL (26676)    VA PRODUCT (50.68)

Name Value
NAME HYDROGEN PEROXIDE 1.7% GEL,DENTAL
VA GENERIC NAME HYDROGEN PEROXIDE
DOSAGE FORM GEL,DENT
ACTIVE INGREDIENTS
STRENGTH 1.7
UNITS %
NATIONAL FORMULARY NAME HYDROGEN PEROXIDE GEL,DENT
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 HYDROGEN PEROXIDE 1.7% DENTAL GEL
VA PRODUCT IDENTIFIER H0690
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4035512
EFFECTIVE DATE/TIME
  • 2016-03-17 00:00:00
    STATUS:   ACTIVE