CLIOQUINOL 3%/HYDROCORTISONE 0.5% CREAM,TOP (4878) VA PRODUCT (50.68)

Name	Value
NAME	CLIOQUINOL 3%/HYDROCORTISONE 0.5% CREAM,TOP
VA GENERIC NAME	CLIOQUINOL/HYDROCORTISONE
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	CLIOQUINOL STRENGTH: 3 UNITS: % HYDROCORTISONE STRENGTH: 0.5 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	CLIOQUINOL/HYDROCORTISONE CREAM,TOP
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2020-07-15 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2020-07-16 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CLIOQUINOL 3/HYDROCORTISONE 0.5% CREAM
VA PRODUCT IDENTIFIER	C0478
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4005420
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE