CARRA FOAM-PERINEAL CLEANSING FOAM (12037)    VA PRODUCT (50.68)

Name Value
NAME CARRA FOAM-PERINEAL CLEANSING FOAM
VA GENERIC NAME CARRINGTON
DOSAGE FORM SOLN,TOP
HAZARDOUS TO DISPOSE NO
CS FEDERAL SCHEDULE Unscheduled
DSS NUMBER 4
NATIONAL FORMULARY NAME CARRINGTON SOLN,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
    COPAY END DATE:   2017-06-30 00:00:00
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-07-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CARRA FOAM-PERINEAL CLEANSING FOAM
VA PRODUCT IDENTIFIER C0658
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4012403
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2012-09-06 00:00:00
    STATUS:   INACTIVE
  • 2012-09-10 00:00:00
    STATUS:   ACTIVE