SODIUM FLUORIDE 2.76%/NA PHOSPHATE,DIBASIC 1.53% PASTE (7397)    VA PRODUCT (50.68)

Name Value
NAME SODIUM FLUORIDE 2.76%/NA PHOSPHATE,DIBASIC 1.53% PASTE
VA GENERIC NAME SODIUM FLUORIDE/SODIUM PHOSPHATE
DOSAGE FORM PASTE
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2008-10-01 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME SODIUM FLUORIDE/SODIUM PHOSPHATE 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 4007902
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2008-10-01 00:00:00
    STATUS:   INACTIVE