SODIUM FLUORIDE 1% GEL (4377)    VA PRODUCT (50.68)

Name Value
NAME SODIUM FLUORIDE 1% GEL
VA GENERIC NAME SODIUM FLUORIDE
DOSAGE FORM GEL
FORMULARY DESIGNATOR TEXT 
Not provided by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
INACTIVATION DATE 2009-11-04 00:00:00
UNITS %
DSS NUMBER 8
NATIONAL FORMULARY NAME SODIUM FLUORIDE GEL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME SODIUM FLUORIDE 1% GEL
VA PRODUCT IDENTIFIER S0506
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4004924
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2009-11-04 00:00:00
    STATUS:   INACTIVE