NICOTINE 15MG/16HRS PATCH (9702)    VA PRODUCT (50.68)

Name Value
NAME NICOTINE 15MG/16HRS PATCH
VA GENERIC NAME NICOTINE
DOSAGE FORM PATCH
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY RESTRICTION 
RESTRICTED TO SMOKING CESSATION PROGRAMS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 15
INACTIVATION DATE 2007-09-24 00:00:00
UNITS MG/16HRS
DSS NUMBER 9
NATIONAL FORMULARY NAME NICOTINE PATCH
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 NICOTINE 15MG/16HR PATCH
VA PRODUCT IDENTIFIER N0502
TRANSMIT TO CMOP YES
VA DISPENSE UNIT PATCH
MASTER ENTRY FOR VUID YES
VUID 4010111
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-24 00:00:00
    STATUS:   INACTIVE