DAPSONE 5% GEL,TOP (20301)    VA PRODUCT (50.68)

Name Value
NAME DAPSONE 5% GEL,TOP
VA GENERIC NAME DAPSONE
DOSAGE FORM GEL,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 5
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS %
NATIONAL FORMULARY NAME DAPSONE 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:   2017-11-30 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-12-01 00:00:00
PGX ELIGIBLE YES
PGX SUPPRESSED NO
VA PRINT NAME DAPSONE 5% TOP GEL
VA PRODUCT IDENTIFIER D0795
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4028285
EFFECTIVE DATE/TIME
  • 2009-02-06 00:00:00
    STATUS:   ACTIVE