| NAME |
DICLOFENAC NA 1% GEL,TOP KIT |
| VA GENERIC NAME |
DICLOFENAC |
| DOSAGE FORM |
KIT |
| FDA MED GUIDE |
NSAIDs_(Class)_(2022).pdf |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
1 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| UNITS |
% |
| NATIONAL FORMULARY NAME |
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
- COPAY END DATE: 2022-01-26 00:00:00
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2022-01-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DICLOFENAC NA 1% TOP GEL KIT |
| VA PRODUCT IDENTIFIER |
D1138 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036128 |
| EFFECTIVE DATE/TIME |
-
- 2016-10-21 00:00:00
- STATUS: ACTIVE
|
