GLYCERIN/MINERAL OIL/PHENOL LIQUID,TOP (9455)    VA PRODUCT (50.68)

Name Value
NAME GLYCERIN/MINERAL OIL/PHENOL LIQUID,TOP
VA GENERIC NAME GLYCERIN/MINERAL OIL/PHENOL
DOSAGE FORM LIQUID,TOP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
DSS NUMBER 1
NATIONAL FORMULARY NAME GLYCERIN/MINERAL OIL/PHENOL LIQUID,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 P & S TOP LIQUID
VA PRODUCT IDENTIFIER P0388
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4009877
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2012-01-04 00:00:00
    STATUS:   INACTIVE
  • 2012-01-04 00:00:00
    STATUS:   INACTIVE
  • 2012-01-04 00:00:00
    STATUS:   INACTIVE
  • 2012-01-04 00:00:00
    STATUS:   INACTIVE
  • 2012-01-04 00:00:00
    STATUS:   INACTIVE
  • 2012-01-06 00:00:00
    STATUS:   ACTIVE