POTASSIUM NITRATE 5%/SODIUM FLUORIDE 1.1% TOOTHPASTE (29390)    VA PRODUCT (50.68)

Name Value
NAME POTASSIUM NITRATE 5%/SODIUM FLUORIDE 1.1% TOOTHPASTE
VA GENERIC NAME POTASSIUM NITRATE/SODIUM FLUORIDE
DOSAGE FORM TOOTHPASTE
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME POTASSIUM NITRATE/SODIUM FLUORIDE TOOTHPASTE
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2019-07-11 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POTASSIUM NIT 5%/SOD FL 1.1% TOOTHPASTE
VA PRODUCT IDENTIFIER P1247
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4038546
EFFECTIVE DATE/TIME
  • 2019-07-11 00:00:00
    STATUS:   ACTIVE
  • 2019-07-11 00:00:00
    STATUS:   ACTIVE