CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN INJ,IV (10251)    VA PRODUCT (50.68)

Name Value
NAME CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN INJ,IV
VA GENERIC NAME CYTOMEGALOVIRUS IMMUNE GLOBULIN
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 2.5
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS GM/VIAL
DSS NUMBER 1
NATIONAL FORMULARY NAME CYTOMEGALOVIRUS IMMUNE GLOBULIN INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME CYTOMEGALOVIRUS IMMUNE GLOB HUMAN INJ
VA PRODUCT IDENTIFIER C1278
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4010624
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE