HYDROCORTISONE ACETATE 2%/PRAMOXINE HCL 1% GEL,TOP (26992) VA PRODUCT (50.68)

Name	Value
NAME	HYDROCORTISONE ACETATE 2%/PRAMOXINE HCL 1% GEL,TOP
VA GENERIC NAME	HYDROCORTISONE/PRAMOXINE
DOSAGE FORM	GEL,TOP
ACTIVE INGREDIENTS	HYDROCORTISONE ACETATE STRENGTH: 2 UNITS: % PRAMOXINE HYDROCHLORIDE STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	HYDROCORTISONE/PRAMOXINE GEL,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%/PRAMOXINE 1% TOP GEL
VA PRODUCT IDENTIFIER	H0697
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4035856
EFFECTIVE DATE/TIME	2016-07-01 00:00:00 STATUS: ACTIVE