SALICYLIC ACID 1%/NA THIOSULFATE 25% LOTION (5890) VA PRODUCT (50.68)

Name	Value
NAME	SALICYLIC ACID 1%/NA THIOSULFATE 25% LOTION
VA GENERIC NAME	SALICYLIC ACID/SODIUM THIOSULFATE
DOSAGE FORM	LOTION
ACTIVE INGREDIENTS	SODIUM THIOSULFATE STRENGTH: 25 UNITS: % SALICYLIC ACID STRENGTH: 1 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	SALICYLIC ACID/SODIUM THIOSULFATE LOTION
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4006413
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE