BENZOIC ACID 12%/SALICYLIC ACID 6% CREAM,TOP (9127) VA PRODUCT (50.68)

Name	Value
NAME	BENZOIC ACID 12%/SALICYLIC ACID 6% CREAM,TOP
VA GENERIC NAME	BENZOIC ACID/SALICYLIC ACID
DOSAGE FORM	CREAM,TOP
ACTIVE INGREDIENTS	STEARYL ALCOHOL PROPYLENE GLYCOL SALICYLIC ACID STRENGTH: 6 UNITS: % CETYL ALCOHOL WATER,PURIFIED PETROLATUM,WHITE SODIUM LAURYL SULFATE SPERMACETI BENZOIC ACID STRENGTH: 12 UNITS: % METHYLPARABEN PROPYLPARABEN POLYSORBATE 80
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	BENZOIC ACID/SALICYLIC ACID CREAM,TOP
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	BENZOIC ACID 12/SALICYLIC ACID 6% CREAM
VA PRODUCT IDENTIFIER	B0114
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	GM
MASTER ENTRY FOR VUID	YES
VUID	4009562
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE