| NAME |
MOISTURIZER,VAGINAL GEL APPLICATOR (EQV-REPHRESH) |
| VA GENERIC NAME |
MOISTURIZER |
| DOSAGE FORM |
GEL,VAG |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
MOISTURIZER GEL,VAG |
| 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 |
MOISTURIZE VAG GEL APPLIC (EQV-REPHRESH) |
| VA PRODUCT IDENTIFIER |
M1145 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
EA |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035811 |
| EFFECTIVE DATE/TIME |
-
- 2016-06-20 00:00:00
- STATUS: ACTIVE
|
