CAPSAICIN/LIDOCAINE/MENTHOL/METHYL SALICYLATE OINT,TOP (23664)    VA PRODUCT (50.68)

Name Value
NAME CAPSAICIN/LIDOCAINE/MENTHOL/METHYL SALICYLATE OINT,TOP
VA GENERIC NAME CAPSAICIN/ LIDOCAINE/MENTHOL/METHYL SALICYLATE
DOSAGE FORM OINT,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
NATIONAL FORMULARY NAME CAPSAICIN/ LIDOCAINE/MENTHOL/METHYL SALICYLATE OINT,TOP
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 LIDOPRO TOP OINT
VA PRODUCT IDENTIFIER L0572
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4032149
EFFECTIVE DATE/TIME
  • 2013-02-22 00:00:00
    STATUS:   ACTIVE
  • 2018-06-15 00:00:00
    STATUS:   INACTIVE
  • 2018-11-06 00:00:00
    STATUS:   ACTIVE