| NAME |
BLASTX WOUND GEL,TOP |
| VA GENERIC NAME |
BLASTX |
| DOSAGE FORM |
GEL,TOP |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| NATIONAL FORMULARY NAME |
BLASTX GEL,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-06-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
BLASTX WOUND TOP GEL |
| VA PRODUCT IDENTIFIER |
B0869 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037516 |
| EFFECTIVE DATE/TIME |
-
- 2018-05-09 00:00:00
- STATUS: ACTIVE
|
