BENZALKONIUM CL 0.12%/BENZOCAINE 20%/ZINC CL 0.1% GEL,DENT (9810) VA PRODUCT (50.68)

Name	Value
NAME	BENZALKONIUM CL 0.12%/BENZOCAINE 20%/ZINC CL 0.1% GEL,DENT
VA GENERIC NAME	BENZALKONIUM CHLORIDE/BENZOCAINE/ZINC CHLORIDE
DOSAGE FORM	GEL,DENT
ACTIVE INGREDIENTS	ZINC CHLORIDE STRENGTH: 0.1 UNITS: % PROPYLENE GLYCOL ALLANTOIN EDETATE TRISODIUM PROPYL GALLATE POLYETHYLENE GLYCOL BENZOCAINE STRENGTH: 20 UNITS: % BENZALKONIUM CHLORIDE STRENGTH: 0.12 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2012-01-04 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	BENZALKONIUM CHLORIDE/BENZOCAINE/ZINC CHLORIDE GEL,DENT
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4010212
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE 2007-10-10 00:00:00 STATUS: ACTIVE 2012-01-04 00:00:00 STATUS: INACTIVE