SODIUM LAURYL SO4 15%/LAURAMIDE DEA SHAMPOO (8266)    VA PRODUCT (50.68)

Name Value
NAME SODIUM LAURYL SO4 15%/LAURAMIDE DEA SHAMPOO
VA GENERIC NAME LAURAMIDE DEA/SODIUM LAURYL SULFATE
DOSAGE FORM SHAMPOO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2007-10-01 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME LAURAMIDE DEA/SODIUM LAURYL SULFATE 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
    COPAY END DATE:   2017-06-30 00:00:00
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-07-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME NON MEDICATED SHAMPOO
VA PRODUCT IDENTIFIER N0149
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4008736
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-25 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2007-10-01 00:00:00
    STATUS:   INACTIVE