ALCLOXA 0.2%/PRAMOXINE 1%/WITCH HAZEL 50% WIPE (10029) VA PRODUCT (50.68)

Name	Value
NAME	ALCLOXA 0.2%/PRAMOXINE 1%/WITCH HAZEL 50% WIPE
VA GENERIC NAME	ALCLOXA/PRAMOXINE/WITCH HAZEL
DOSAGE FORM	PAD,TOP
ACTIVE INGREDIENTS	PROPYLENE GLYCOL WITCH HAZEL STRENGTH: 50 UNITS: % ALCLOXA STRENGTH: 0.2 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-28 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ALCLOXA/PRAMOXINE/WITCH HAZEL PAD,TOP
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	ALCLOXA 0.2/PRAMOXN 1/WTCH HAZL 50% WIPE
VA PRODUCT IDENTIFIER	A0785
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4010418
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE