| NAME |
CAPSAICIN 0.025% CREAM/DICLOFENAC NA 1.5% SOLN,TOP KIT |
| VA GENERIC NAME |
CAPSAICIN/DICLOFENAC |
| DOSAGE FORM |
KIT |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
CAPSAICIN/DICLOFENAC KIT |
| 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 |
CAPSAICIN 0.025%/DICLOFENAC 1.5% KIT |
| VA PRODUCT IDENTIFIER |
C1766 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035588 |
| EFFECTIVE DATE/TIME |
-
- 2016-04-01 00:00:00
- STATUS: ACTIVE
|
