BENZOCAINE 2%/COAL TAR 48.5%/SALICYLIC ACID 1% LOTION (10087) VA PRODUCT (50.68)

Name	Value
NAME	BENZOCAINE 2%/COAL TAR 48.5%/SALICYLIC ACID 1% LOTION
VA GENERIC NAME	ALCOHOL/BENZOCAINE/COAL TAR/SALICYLIC ACID
DOSAGE FORM	LOTION
ACTIVE INGREDIENTS	SALICYLIC ACID STRENGTH: 1 UNITS: % ALCOHOL STRENGTH: 81 UNITS: % COAL TAR SOLUTION STRENGTH: 48.5 UNITS: % BENZOCAINE STRENGTH: 2 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2011-07-08 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ALCOHOL/BENZOCAINE/COAL TAR/SALICYLIC ACID LOTION
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	BENZO 2/COAL TAB 48.5/SAL ACID 1% LOTION
VA PRODUCT IDENTIFIER	B0566
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4010471
EFFECTIVE DATE/TIME	2002-10-30 00:00:00 STATUS: INACTIVE 2005-12-08 00:00:00 STATUS: INACTIVE 2007-04-25 00:00:00 STATUS: ACTIVE 2011-07-08 00:00:00 STATUS: INACTIVE