SULFACETAMIDE NA 10%/SULFUR 5% GEL,TOP (16774) VA PRODUCT (50.68)

Name	Value
NAME	SULFACETAMIDE NA 10%/SULFUR 5% GEL,TOP
VA GENERIC NAME	SULFACETAMIDE/SULFUR
DOSAGE FORM	GEL,TOP
ACTIVE INGREDIENTS	SULFUR STRENGTH: 5 UNITS: % SULFACETAMIDE SODIUM STRENGTH: 10 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
INACTIVATION DATE	2017-05-15 00:00:00
NATIONAL FORMULARY NAME	SULFACETAMIDE/SULFUR GEL,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2017-04-30 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2017-05-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	SULFACETAMIDE NA 10%/SULFUR 5% TOP GEL
VA PRODUCT IDENTIFIER	S0419
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4017137
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE