LIDOCAINE 2.5%/PRILOCAINE 2.5% GEL,DENT (18353)    VA PRODUCT (50.68)

Name Value
NAME LIDOCAINE 2.5%/PRILOCAINE 2.5% GEL,DENT
VA GENERIC NAME LIDOCAINE/PRILOCAINE
DOSAGE FORM GEL,DENT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
NATIONAL FORMULARY NAME LIDOCAINE/PRILOCAINE GEL,DENT
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 LIDOCAINE 2.5%/PRILOCAINE 2.5% DENT GEL
VA PRODUCT IDENTIFIER L0395
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4026133
EFFECTIVE DATE/TIME
  • 2007-06-19 00:00:00
    STATUS:   ACTIVE
  • 2008-09-02 00:00:00
    STATUS:   INACTIVE
  • 2009-05-11 00:00:00
    STATUS:   ACTIVE
  • 2011-05-26 00:00:00
    STATUS:   INACTIVE
  • 2011-09-12 00:00:00
    STATUS:   ACTIVE