SODIUM BIPHOSPHATE 0.2%/SODIUM FLUORIDE 2.73% PASTE,DENT (7356)    VA PRODUCT (50.68)

Name Value
NAME SODIUM BIPHOSPHATE 0.2%/SODIUM FLUORIDE 2.73% PASTE,DENT
VA GENERIC NAME SODIUM BIPHOSPHATE/SODIUM FLUORIDE
DOSAGE FORM PASTE
FORMULARY DESIGNATOR TEXT 
Not provided by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2007-10-01 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME SODIUM BIPHOSPHATE/SODIUM FLUORIDE PASTE
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 4007861
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-10-01 00:00:00
    STATUS:   INACTIVE