COAL TAR 4.3% SHAMPOO (13453)    VA PRODUCT (50.68)

Name Value
NAME COAL TAR 4.3% SHAMPOO
VA GENERIC NAME COAL TAR
DOSAGE FORM SHAMPOO
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4.3
INACTIVATION DATE 2000-11-13 00:00:00
UNITS %
NATIONAL FORMULARY NAME COAL TAR SHAMPOO
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 COAL TAR 4.3% SHAMPOO
VA PRODUCT IDENTIFIER C0876
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4013818
EFFECTIVE DATE/TIME
  • 2000-11-13 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE