ALLERGENIC EXTRACT,ODACTRA 12-SQ-HDM TAB,SL (28261)    VA PRODUCT (50.68)

Name Value
NAME ALLERGENIC EXTRACT,ODACTRA 12-SQ-HDM TAB,SL
VA GENERIC NAME ALLERGENIC EXTRACT
DOSAGE FORM TAB,SUBLINGUAL
FDA MED GUIDE Allergen_Extract_House_Dust_Mite_(Odactra)_(2017).PDF
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME ALLERGENIC EXTRACT TAB,SUBLINGUAL
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2018-03-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ALLERGENIC EXTR,ODACTRA 12-SQ-HDM SL TAB
VA PRODUCT IDENTIFIER A1968
TRANSMIT TO CMOP YES
VA DISPENSE UNIT TAB
MASTER ENTRY FOR VUID YES
VUID 4037250
EFFECTIVE DATE/TIME
  • 2018-01-26 00:00:00
    STATUS:   ACTIVE