BENZOPHENONE-3/PARA-AMINOBENZOIC ACID LOTION (10129) VA PRODUCT (50.68)

Name	Value
NAME	BENZOPHENONE-3/PARA-AMINOBENZOIC ACID LOTION
VA GENERIC NAME	BENZOPHENONE-3/PARA-AMINOBENZOIC ACID
DOSAGE FORM	LOTION
ACTIVE INGREDIENTS	LANOLIN OIL PARA-AMINOBENZOIC ACID BENZOPHENONE-3 ALOE VERA COCOA BUTTER
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BENZOPHENONE-3/PARA-AMINOBENZOIC 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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4010509
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE