HYDROCORTISONE ACETATE 2.5%/PRAMOXINE HCL 1% OINT,TOP (24912) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCORTISONE ACETATE 2.5%/PRAMOXINE HCL 1% OINT,TOP
VA GENERIC NAME	HYDROCORTISONE/PRAMOXINE
DOSAGE FORM	OINT,TOP
ACTIVE INGREDIENTS	HYDROCORTISONE ACETATE STRENGTH: 2.5 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	HYDROCORTISONE/PRAMOXINE OINT,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	HYDROCORTISONE 2.5/PRAMOXINE 1% TOP OINT
VA PRODUCT IDENTIFIER	H0667
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4033554
EFFECTIVE DATE/TIME	2014-07-29 00:00:00 STATUS: ACTIVE