BENZOYL PEROXIDE 5.5% LOTION (4764)    VA PRODUCT (50.68)

Name Value
NAME BENZOYL PEROXIDE 5.5% LOTION
VA GENERIC NAME BENZOYL PEROXIDE
DOSAGE FORM LOTION
HAZARDOUS TO DISPOSE NO
DOT SHIPPING CODE

ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 5.5
INACTIVATION DATE 2011-02-04 00:00:00
UNITS %
DSS NUMBER 12
NATIONAL FORMULARY NAME BENZOYL PEROXIDE LOTION
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 BENZOYL PEROXIDE 5.5% LOTION
VA PRODUCT IDENTIFIER B0287
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4005310
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-02-04 00:00:00
    STATUS:   INACTIVE