SUNSCREEN 30-50/AVOBENZONE/PABA-FREE COMBO LOTION (24995)    VA PRODUCT (50.68)

Name Value
NAME SUNSCREEN 30-50/AVOBENZONE/PABA-FREE COMBO LOTION
VA GENERIC NAME SUNSCREEN PABA-FREE
DOSAGE FORM LOTION,TOP
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME SUNSCREEN PABA-FREE LOTION,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 SUNSCREEN 30-50/AVOBENZONE/PABA-F LOTION
VA PRODUCT IDENTIFIER S0744
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4033645
EFFECTIVE DATE/TIME
  • 2014-09-02 00:00:00
    STATUS:   ACTIVE