COAL TAR 1%/SALICYLIC ACID 2%/SULFUR 2% SHAMPOO (22714) VA PRODUCT (50.68)

Name	Value
NAME	COAL TAR 1%/SALICYLIC ACID 2%/SULFUR 2% SHAMPOO
VA GENERIC NAME	COAL TAR/SALICYLIC ACID/SULFUR
DOSAGE FORM	SHAMPOO
ACTIVE INGREDIENTS	COAL TAR STRENGTH: 1 UNITS: % SALICYLIC ACID STRENGTH: 2 UNITS: % SULFUR STRENGTH: 2 UNITS: %
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Multisource
INACTIVATION DATE	2017-10-30 00:00:00
NATIONAL FORMULARY NAME	COAL TAR/SALICYLIC ACID/SULFUR 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 1/SAL AC 2/SULFUR 2% SHAMPOO
VA PRODUCT IDENTIFIER	C1494
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4031063
EFFECTIVE DATE/TIME	2011-11-04 00:00:00 STATUS: ACTIVE 2017-10-30 00:00:00 STATUS: INACTIVE