STANNOUS FLUORIDE 4% LIQUID,DENT (6784)    VA PRODUCT (50.68)

Name Value
NAME STANNOUS FLUORIDE 4% LIQUID,DENT
VA GENERIC NAME STANNOUS FLUORIDE
DOSAGE FORM LIQUID,DENT
FORMULARY DESIGNATOR TEXT 
Not provided by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4
INACTIVATION DATE 2007-10-01 00:00:00
UNITS %
DSS NUMBER 8
NATIONAL FORMULARY NAME STANNOUS FLUORIDE LIQUID
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
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID YES
VUID 4007300
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-10-01 00:00:00
    STATUS:   INACTIVE