ALOE 1%/HC 2%/IODOQUINOL 1% GEL,TOP (27948)    VA PRODUCT (50.68)

Name Value
NAME ALOE 1%/HC 2%/IODOQUINOL 1% GEL,TOP
VA GENERIC NAME ALOE/HYDROCORTISONE/IODOQUINOL
DOSAGE FORM GEL,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME ALOE/HYDROCORTISONE/IODOQUINOL GEL,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-11-01 00:00:00
    COPAY END DATE:   2017-11-30 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-12-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME ALOE 1%/HC 2%/IODOQUINOL 1% TOP GEL
VA PRODUCT IDENTIFIER A1952
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4036927
EFFECTIVE DATE/TIME
  • 2017-10-12 00:00:00
    STATUS:   ACTIVE