ALLANTOIN 0.5%/DIPHENHYDRAMINE HCL 2% CREAM,TOP (24960)    VA PRODUCT (50.68)

Name Value
NAME ALLANTOIN 0.5%/DIPHENHYDRAMINE HCL 2% CREAM,TOP
VA GENERIC NAME ALLANTOIN/DIPHENHYDRAMINE
DOSAGE FORM CREAM,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
INACTIVATION DATE 2017-12-15 00:00:00
NATIONAL FORMULARY NAME ALLANTOIN/DIPHENHYDRAMINE CREAM,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 ALLANTOIN 0.5%/DIPHENHYDRAMINE 2% CREAM
VA PRODUCT IDENTIFIER A1762
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4033608
EFFECTIVE DATE/TIME
  • 2014-08-21 00:00:00
    STATUS:   ACTIVE
  • 2017-12-15 00:00:00
    STATUS:   INACTIVE