CHOLESTEROL 3%/PETROLATUM 86%/STEARYL ALCOHOL 3%/WAX 6% OINT,TOP (9008)    VA PRODUCT (50.68)

Name Value
NAME CHOLESTEROL 3%/PETROLATUM 86%/STEARYL ALCOHOL 3%/WAX 6% OINT,TOP
VA GENERIC NAME CHOLESTEROL/PETROLATUM/STEARYL ALCOHOL/WAX
DOSAGE FORM OINT,TOP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2007-09-19 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME CHOLESTEROL/PETROLATUM/STEARYL ALCOHOL/WAX OINT,TOP
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 HYDROPHILIC OINT
VA PRODUCT IDENTIFIER H0071
TRANSMIT TO CMOP NO
VA DISPENSE UNIT GM
MASTER ENTRY FOR VUID YES
VUID 4009450
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-19 00:00:00
    STATUS:   INACTIVE