MICONAZOLE NITRATE 0.25%/ZINC OXIDE 15% OINT,TOP (17895)    VA PRODUCT (50.68)

Name Value
NAME MICONAZOLE NITRATE 0.25%/ZINC OXIDE 15% OINT,TOP
VA GENERIC NAME MICONAZOLE/ZINC
DOSAGE FORM OINT,TOP
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME MICONAZOLE/ZINC OINT,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:   2018-11-14 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2018-11-15 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME MICONAZOLE 0.25/ZINC OXIDE 15% TOP OINT
VA PRODUCT IDENTIFIER M0692
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4025582
EFFECTIVE DATE/TIME
  • 2006-09-05 00:00:00
    STATUS:   ACTIVE