ACID MANTLE CREAM (13795)    VA PRODUCT (50.68)

Name Value
NAME ACID MANTLE CREAM
VA GENERIC NAME ACID MANTLE
DOSAGE FORM CREAM
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2016-05-24 00:00:00
NATIONAL FORMULARY NAME ACID MANTLE CREAM
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 ACID MANTLE CREAM
VA PRODUCT IDENTIFIER A1040
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4014160
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE