DIMETHICONE 5% CREAM/LIDOCAINE 5% PATCH KIT,15 (27116)    VA PRODUCT (50.68)

Name Value
NAME DIMETHICONE 5% CREAM/LIDOCAINE 5% PATCH KIT,15
VA GENERIC NAME DIMETHICONE/LIDOCAINE
DOSAGE FORM KIT
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2022-03-15 00:00:00
NATIONAL FORMULARY NAME DIMETHICONE/LIDOCAINE KIT
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 DIMETHIC 5%CRM/LIDOCAINE 5% PATCH KIT 15
VA PRODUCT IDENTIFIER D1133
TRANSMIT TO CMOP YES
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4035993
EFFECTIVE DATE/TIME
  • 2016-08-18 00:00:00
    STATUS:   ACTIVE
  • 2022-03-15 00:00:00
    STATUS:   INACTIVE