TRIETHANOLAMINE POLYPEPTIDE OLEATE CONDENSATE 10% LIQUID,OTIC (4230)    VA PRODUCT (50.68)

Name Value
NAME TRIETHANOLAMINE POLYPEPTIDE OLEATE CONDENSATE 10% LIQUID,OTIC
VA GENERIC NAME TRIETHANOLAMINE
DOSAGE FORM LIQUID,OTIC
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 10
INACTIVATION DATE 2009-05-20 00:00:00
UNITS %
DSS NUMBER 1
NATIONAL FORMULARY NAME TRIETHANOLAMINE LIQUID,OTIC
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 TRIETHANOLAMINE POLYPEPTIDE 10% OTIC LIQ
VA PRODUCT IDENTIFIER T0102
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4004782
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2009-05-20 00:00:00
    STATUS:   INACTIVE