ANTI-FUNGAL NAIL TREATMENT (9927) VA PRODUCT (50.68)

Name	Value
NAME	ANTI-FUNGAL NAIL TREATMENT
VA GENERIC NAME	ALCOHOL/BENZOCAINE/CHOROXYLENOL/RESORCINOL/SALICYLIC ACID
DOSAGE FORM	LIQUID,TOP
ACTIVE INGREDIENTS	ISOPROPYL ALCOHOL STRENGTH: 50 UNITS: % SALICYLIC ACID STRENGTH: 2 UNITS: % CHLOROXYLENOL STRENGTH: 2 UNITS: % RESORCINOL STRENGTH: 1 UNITS: % BENZOCAINE STRENGTH: 0.5 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	1
NATIONAL FORMULARY NAME	ALCOHOL/BENZOCAINE/CHOROXYLENOL/RESORCINOL/SALICYLIC ACID LIQUID,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	ANTI-FUNGAL NAIL TREATMENT
VA PRODUCT IDENTIFIER	A0869
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4010320
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE