BENZETHONIUM CL 0.12% SPRAY,TOP (27585)    VA PRODUCT (50.68)

Name Value
NAME BENZETHONIUM CL 0.12% SPRAY,TOP
VA GENERIC NAME BENZETHONIUM CHLORIDE
DOSAGE FORM SPRAY,TOP
FORMULARY DESIGNATOR TEXT 
Not supplied by pharmacy for inpatient use.
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 0.12
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS %
NATIONAL FORMULARY NAME BENZETHONIUM CHLORIDE SPRAY,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-05-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME BENZETHONIUM CL 0.12% TOP SPRAY
VA PRODUCT IDENTIFIER B0836
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4036506
EFFECTIVE DATE/TIME
  • 2017-03-24 00:00:00
    STATUS:   ACTIVE