HYDROCORTISONE ACETATE 2.5%/PRAMOXINE HCL 1% CREAM,TOP (3483)    VA PRODUCT (50.68)

Name Value
NAME HYDROCORTISONE ACETATE 2.5%/PRAMOXINE HCL 1% CREAM,TOP
VA GENERIC NAME HYDROCORTISONE/PRAMOXINE
DOSAGE FORM CREAM,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Multisource
DSS NUMBER 9
NATIONAL FORMULARY NAME HYDROCORTISONE/PRAMOXINE CREAM,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME HYDROCORTISONE 2.5/PRAMOXIN 1% TOP CREAM
VA PRODUCT IDENTIFIER H0124
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4004046
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE