BENZOIC ACID/EUCALYPTOL/METHYL SALICYLATE/THYMOL LIQUID (31302) VA PRODUCT (50.68)

Name	Value
NAME	BENZOIC ACID/EUCALYPTOL/METHYL SALICYLATE/THYMOL LIQUID
VA GENERIC NAME	BENZOIC ACID/EUCALYPTOL/METHYL SALICYLATE/THYMOL
DOSAGE FORM	LIQUID
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	MENTHOL EUCALYPTOL THYMOL METHYL SALICYLATE POLOXAMER 407 BENZOIC ACID
NATIONAL FORMULARY NAME	BENZOIC ACID/EUCALYPTOL/METHYL SALICYLATE/THYMOL LIQUID
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2021-07-20 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	ANTISEPTIC MOUTHWASH (AF)
VA PRODUCT IDENTIFIER	A2097
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4040674
EFFECTIVE DATE/TIME	2021-07-20 00:00:00 STATUS: ACTIVE 2021-07-20 00:00:00 STATUS: ACTIVE