BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% SUSP,TOP (19995) VA PRODUCT (50.68)

Name	Value
NAME	BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% SUSP,TOP
VA GENERIC NAME	BETAMETHASONE/CALCIPOTRIENE
DOSAGE FORM	SUSP,TOP
ACTIVE INGREDIENTS	BETAMETHASONE DIPROPIONATE STRENGTH: 0.064 UNITS: % CALCIPOTRIENE STRENGTH: 0.005 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	BETAMETHASONE/CALCIPOTRIENE SUSP,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: 2020-01-29 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2020-01-30 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	BETAMETH 0.064/CALCIPOTRIENE 0.005% SUSP
VA PRODUCT IDENTIFIER	B0609
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4027943
EFFECTIVE DATE/TIME	2008-10-08 00:00:00 STATUS: ACTIVE