ACYCLOVIR 5%/HYDROCORTISONE 1% CREAM,TOP (24539) VA PRODUCT (50.68)

Name	Value
NAME	ACYCLOVIR 5%/HYDROCORTISONE 1% CREAM,TOP
VA GENERIC NAME	ACYCLOVIR/HYDROCORTISONE
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	ACYCLOVIR STRENGTH: 5 UNITS: % HYDROCORTISONE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	ACYCLOVIR/HYDROCORTISONE CREAM,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
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ACYCLOVIR 5%/HYDROCORTISONE 1% TOP CREAM
VA PRODUCT IDENTIFIER	A1744
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4033132
EFFECTIVE DATE/TIME	2014-02-28 00:00:00 STATUS: ACTIVE