MINERAL OIL 1.4GM/5ML EMULSION (8667) VA PRODUCT (50.68)

Name	Value
NAME	MINERAL OIL 1.4GM/5ML EMULSION
VA GENERIC NAME	MINERAL OIL
DOSAGE FORM	EMULSION
ACTIVE INGREDIENTS	MINERAL OIL STRENGTH: 1.4 UNITS: GM/5ML WATER TRAGACANTH GLYCERIN AGAR ALBUMIN,EGG ACACIA SODIUM BENZOATE BENZOIC ACID SODIUM HYDROXIDE CITRIC ACID
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	4.2
INACTIVATION DATE	2007-09-28 00:00:00
UNITS	GM/15ML
DSS NUMBER	7
NATIONAL FORMULARY NAME	MINERAL OIL EMULSION
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
TRANSMIT TO CMOP	NO
MASTER ENTRY FOR VUID	YES
VUID	4009125
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE 2007-09-28 00:00:00 STATUS: INACTIVE