BENZOCAINE 14%/BUTAMBEN 2%/TETRACAINE 2% GEL,TOP (7342)    VA PRODUCT (50.68)

Name Value
NAME BENZOCAINE 14%/BUTAMBEN 2%/TETRACAINE 2% GEL,TOP
VA GENERIC NAME BENZOCAINE/BUTAMBEN/TETRACAINE
DOSAGE FORM GEL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2011-06-02 00:00:00
DSS NUMBER 4
NATIONAL FORMULARY NAME BENZOCAINE/BUTAMBEN/TETRACAINE GEL
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 CETACAINE TOP GEL
VA PRODUCT IDENTIFIER B0033
TRANSMIT TO CMOP YES
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4007847
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2011-06-02 00:00:00
    STATUS:   INACTIVE