BENZOYL PEROXIDE 3%/TRETINOIN 0.1% CREAM,TOP (31777) VA PRODUCT (50.68)

Name	Value
NAME	BENZOYL PEROXIDE 3%/TRETINOIN 0.1% CREAM,TOP
VA GENERIC NAME	BENZOYL PEROXIDE/TRETINOIN
DOSAGE FORM	CREAM,TOP
HAZARDOUS TO DISPOSE	NO
PRIMARY EPA CODE	D001-IGNITABLE
ACTIVE INGREDIENTS	TRETINOIN STRENGTH: 0.1 UNITS: % BENZOYL PEROXIDE STRENGTH: 3 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
NATIONAL FORMULARY NAME	BENZOYL PEROXIDE/TRETINOIN CREAM,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2022-03-03 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	BENZOYL PEROX 3%/TRETINOIN 0.1% TOP CR
VA PRODUCT IDENTIFIER	B0933
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4041207
EFFECTIVE DATE/TIME	2022-03-03 00:00:00 STATUS: ACTIVE