| NAME |
IONTOPHORESIS PATCH, IONTOPATCH-80 |
| VA GENERIC NAME |
SUPPLY |
| DOSAGE FORM |
IONTOPHORETIC SYSTEM |
| HAZARDOUS TO DISPOSE |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
SUPPLY IONTOPHORETIC SYSTEM |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2023-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
IONTOPHORESIS PATCH, IONTOPATCH-80 |
| VA PRODUCT IDENTIFIER |
I0755 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
PATCH |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4042059 |
| EFFECTIVE DATE/TIME |
-
- 2023-03-01 00:00:00
- STATUS: ACTIVE
|
