ALLANTOIN 120MG/AMINACRINE 12MG/SULFISOXAZOLE 600MG SUPP,VAG (6212) VA PRODUCT (50.68)

Name	Value
NAME	ALLANTOIN 120MG/AMINACRINE 12MG/SULFISOXAZOLE 600MG SUPP,VAG
VA GENERIC NAME	ALLANTOIN/AMINACRINE/SULFISOXAZOLE
DOSAGE FORM	SUPP,VAG
ACTIVE INGREDIENTS	ALLANTOIN STRENGTH: 120 UNITS: MG AMINACRINE HYDROCHLORIDE STRENGTH: 12 UNITS: MG SULFISOXAZOLE STRENGTH: 600 UNITS: MG
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2007-09-18 00:00:00
DSS NUMBER	2
NATIONAL FORMULARY NAME	ALLANTOIN/AMINACRINE/SULFISOXAZOLE SUPP,VAG
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	SULFISOXASOLE 600MG VAG SUPP
VA PRODUCT IDENTIFIER	A0125
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4006733
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-18 00:00:00 STATUS: INACTIVE