ACETIC ACID 0.9%/OXYQUINOLINE SO4 0.025% GEL,VAG (13730)    VA PRODUCT (50.68)

Name Value
NAME ACETIC ACID 0.9%/OXYQUINOLINE SO4 0.025% GEL,VAG
VA GENERIC NAME ACETIC ACID/OXYQUINOLINE
DOSAGE FORM GEL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME ACETIC ACID/OXYQUINOLINE GEL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ACETIC AC 0.9/OXYQUINOLIN 0.025% VAG GEL
VA PRODUCT IDENTIFIER A1038
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4014095
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE