DALTEPARIN NA 5000UNT/0.2ML SYRINGE (12361) VA PRODUCT (50.68)

Name	Value
NAME	DALTEPARIN NA 5000UNT/0.2ML SYRINGE
VA GENERIC NAME	DALTEPARIN
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	DALTEPARIN SODIUM STRENGTH: 5000 UNITS: UNIT/0.2ML
NATIONAL FORMULARY RESTRICTION	Class review in progress
CS FEDERAL SCHEDULE	Unscheduled
STRENGTH	5000
SINGLE/MULTI SOURCE PRODUCT	Single source
UNITS	UNIT/0.2ML
DSS NUMBER	2
NATIONAL FORMULARY NAME	DALTEPARIN INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	DALTEPARIN NA 5000 UNT/0.2ML SYRINGE
VA PRODUCT IDENTIFIER	D0321
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4012727
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE