UREA 30% FOAM,TOP (24159)    VA PRODUCT (50.68)

Name Value
NAME UREA 30% FOAM,TOP
VA GENERIC NAME UREA
DOSAGE FORM FOAM,TOP
ACTIVE INGREDIENTS
  • UREA
    STRENGTH:   30
    UNITS:   %
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 30
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2021-12-15 00:00:00
UNITS %
NATIONAL FORMULARY NAME UREA FOAM,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:   2021-09-02 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2021-09-03 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME UREA 30% TOP FOAM
VA PRODUCT IDENTIFIER U0067
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4032699
EFFECTIVE DATE/TIME
  • 2013-09-17 00:00:00
    STATUS:   ACTIVE
  • 2021-12-15 00:00:00
    STATUS:   INACTIVE