GLYCERIN 50%/SODIUM CHLORIDE 0.9%/PHENOL 0.4% INJ (6765)    VA PRODUCT (50.68)

Name Value
NAME GLYCERIN 50%/SODIUM CHLORIDE 0.9%/PHENOL 0.4% INJ
VA GENERIC NAME GLYCERIN/PHENOL/SODIUM CHLORIDE
DOSAGE FORM INJ,SOLN
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2022-01-10 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME GLYCERIN/PHENOL/SODIUM CHLORIDE INJ,SOLN
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 GLYCERIN 50%/NACL 0.9%/PHENOL 0.4%
VA PRODUCT IDENTIFIER XL025
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4007281
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2022-01-10 00:00:00
    STATUS:   INACTIVE