| NAME |
AZTREONAM 40MG/ML/DEXTROSE 5% INJ |
| VA GENERIC NAME |
AZTREONAM/DEXTROSE |
| DOSAGE FORM |
INJ |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
40 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2019-07-15 00:00:00 |
| UNITS |
MG/ML |
| DSS NUMBER |
2 |
| NATIONAL FORMULARY NAME |
AZTREONAM/DEXTROSE INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| 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 |
AZTREONAM 40MG/ML/DEXTROSE 5% INJ |
| VA PRODUCT IDENTIFIER |
A0945 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4012112 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2019-07-15 00:00:00
- STATUS: INACTIVE
-
- 2019-07-15 00:00:00
- STATUS: INACTIVE
|
