| NAME |
BALSAM PERU 7.25%/CASTOR OIL 65%/TRYPSIN 0.01% AEROSOL,TOP |
| VA GENERIC NAME |
BALSAM PERU/CASTOR OIL/TRYPSIN |
| DOSAGE FORM |
AEROSOL,TOP |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2009-09-17 00:00:00 |
| DSS NUMBER |
1 |
| NATIONAL FORMULARY NAME |
BALSAM PERU/CASTOR OIL/TRYPSIN AEROSOL,TOP |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
GRANULDERM SPRAY |
| VA PRODUCT IDENTIFIER |
B0018 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
GM |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4010070 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2009-09-17 00:00:00
- STATUS: INACTIVE
|
