BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% FOAM,TOP (26468) VA PRODUCT (50.68)

Name	Value
NAME	BETAMETHASONE DIPROPIONATE 0.064%/CALCIPOTRIENE 0.005% FOAM,TOP
VA GENERIC NAME	BETAMETHASONE/CALCIPOTRIENE
DOSAGE FORM	FOAM,TOP
ACTIVE INGREDIENTS	BETAMETHASONE DIPROPIONATE STRENGTH: 0.064 UNITS: % CALCIPOTRIENE STRENGTH: 0.005 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	BETAMETHASONE/CALCIPOTRIENE FOAM,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	BETAMETH 0.064/CALCIPOTRIENE 0.005% FOAM
VA PRODUCT IDENTIFIER	B0804
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4035293
EFFECTIVE DATE/TIME	2016-01-14 00:00:00 STATUS: ACTIVE