ADAPALENE 0.1%/BENZOYL PEROXIDE 2.5% GEL,TOP (21437)    VA PRODUCT (50.68)

Name Value
NAME ADAPALENE 0.1%/BENZOYL PEROXIDE 2.5% GEL,TOP
VA GENERIC NAME ADAPALENE/BENZOYL PEROXIDE
DOSAGE FORM GEL,TOP
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME ADAPALENE/BENZOYL PEROXIDE 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 NO
PGX SUPPRESSED NO
VA PRINT NAME ADAPALENE 0.1/BENZOYL PEROX 2.5% TOP GEL
VA PRODUCT IDENTIFIER A1541
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4029584
EFFECTIVE DATE/TIME
  • 2010-02-09 00:00:00
    STATUS:   ACTIVE
  • 2010-02-09 00:00:00
    STATUS:   INACTIVE
  • 2011-09-12 00:00:00
    STATUS:   ACTIVE
  • 2017-10-06 00:00:00
    STATUS:   INACTIVE
  • 2018-03-13 00:00:00
    STATUS:   ACTIVE