SKIN PROTECTANT,RESTORE H#9976 (12288)    VA PRODUCT (50.68)

Name Value
NAME SKIN PROTECTANT,RESTORE H#9976
VA GENERIC NAME SUPPLY
DOSAGE FORM LIQUID,TOP
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2010-09-22 00:00:00
DSS NUMBER 33
NATIONAL FORMULARY NAME SUPPLY LIQUID,TOP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME SKIN PROTECTANT,RESTORE H#9976
VA PRODUCT IDENTIFIER XX091
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4012654
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2010-09-22 00:00:00
    STATUS:   INACTIVE