BENZETHONIUM CL 0.1%/BENZOCAINE 20%/GLYCERIN SOLN,OTIC (6242) VA PRODUCT (50.68)

Name	Value
NAME	BENZETHONIUM CL 0.1%/BENZOCAINE 20%/GLYCERIN SOLN,OTIC
VA GENERIC NAME	BENZETHONIUM/BENZOCAINE/GLYCERIN/POLYETHYLENE GLYCOL
DOSAGE FORM	SOLN,OTIC
ACTIVE INGREDIENTS	BENZETHONIUM CHLORIDE STRENGTH: 0.1 UNITS: % POLYETHYLENE GLYCOL 300 GLYCERIN BENZOCAINE STRENGTH: 20 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BENZETHONIUM/BENZOCAINE/GLYCERIN/POLYETHYLENE GLYCOL SOLN,OTIC
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	BENZETHONIUM 0.1/BENZOCAIN 20% OTIC SOLN
VA PRODUCT IDENTIFIER	B0053
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4006762
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE