| NAME |
ALLERGENIC EXTRACT, ORALAIR 100-300 IR TAB,SL CHILD PACK,9 |
| VA GENERIC NAME |
ALLERGENIC EXTRACT |
| DOSAGE FORM |
TAB,SUBLINGUAL |
| FDA MED GUIDE |
Allergen_Extract_Mixed_Pollens_(Oralair)_(2016).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 |
ORALAIR 100-300 IR TAB,SL CHILD PACK,9 |
| VA PRODUCT IDENTIFIER |
O0377 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035702 |
| EFFECTIVE DATE/TIME |
-
- 2016-05-13 00:00:00
- STATUS: ACTIVE
|
