BENZALKONIUM CL 0.13%/LIDOCAINE HCL 2.5% SPRAY,TOP (25488) VA PRODUCT (50.68)

Name	Value
NAME	BENZALKONIUM CL 0.13%/LIDOCAINE HCL 2.5% SPRAY,TOP
VA GENERIC NAME	BENZALKONIUM/LIDOCAINE
DOSAGE FORM	SPRAY,TOP
ACTIVE INGREDIENTS	LIDOCAINE HYDROCHLORIDE STRENGTH: 2.5 UNITS: % BENZALKONIUM CHLORIDE STRENGTH: 0.13 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	BENZALKONIUM/LIDOCAINE SPRAY,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	BENZALKONIUM 0.13/LIDOCAINE 2.5% SPRAY
VA PRODUCT IDENTIFIER	B0758
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4034212
EFFECTIVE DATE/TIME	2015-02-20 00:00:00 STATUS: ACTIVE