BENZALKONIUM CL 0.13%/LIDOCAINE HCL 2.5% LIQUID,TOP (14918)    VA PRODUCT (50.68)

Name Value
NAME BENZALKONIUM CL 0.13%/LIDOCAINE HCL 2.5% LIQUID,TOP
VA GENERIC NAME BENZALKONIUM/LIDOCAINE
DOSAGE FORM LIQUID,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME BENZALKONIUM/LIDOCAINE LIQUID,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 BENZALKONIUM 0.13/LIDOCAINE 2.5% TOP LIQ
VA PRODUCT IDENTIFIER B0464
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4015282
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-28 00:00:00
    STATUS:   INACTIVE
  • 2011-09-12 00:00:00
    STATUS:   ACTIVE