| NAME |
HYDROCORTISONE 2%/LIDOCAINE 2% CREAM,RTL W/APPLICATOR |
| VA GENERIC NAME |
HYDROCORTISONE/LIDOCAINE |
| DOSAGE FORM |
CREAM,RTL |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
HYDROCORTISONE/LIDOCAINE CREAM,RTL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
HYDROCORT 2/LIDOCAINE 2% RTL CREAM W/APP |
| VA PRODUCT IDENTIFIER |
XV495 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
TUBE |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4026268 |
| EFFECTIVE DATE/TIME |
-
- 2007-08-30 00:00:00
- STATUS: ACTIVE
|
