| NAME |
DIMETHICONE 5% CREAM/TRIAMCINOLONE ACETONIDE 0.1% OINTMENT,KIT |
| VA GENERIC NAME |
DIMETHICONE/TRIAMCINOLONE |
| DOSAGE FORM |
KIT |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| NATIONAL FORMULARY NAME |
DIMETHICONE/TRIAMCINOLONE KIT |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 3
- COPAY EFFECTIVE DATE: 2017-05-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
DIMETHICONE 5% CREAM/TAC 0.1% OINT KIT |
| VA PRODUCT IDENTIFIER |
D1150 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4036490 |
| EFFECTIVE DATE/TIME |
-
- 2017-03-17 00:00:00
- STATUS: ACTIVE
|