| NAME |
CEFTRIAXONE NA 500MG/VIL/LIDOCAINE 1% INJ,KIT |
| VA GENERIC NAME |
CEFTRIAXONE/LIDOCAINE |
| DOSAGE FORM |
INJ |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2007-09-19 00:00:00 |
| DSS NUMBER |
2 |
| NATIONAL FORMULARY NAME |
CEFTRIAXONE/LIDOCAINE INJ |
| 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 |
CEFTRIAXONE 0.5GM/VIL/LIDOCAIN 1% IJ KIT |
| VA PRODUCT IDENTIFIER |
C0746 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
KIT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4013098 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2007-09-19 00:00:00
- STATUS: INACTIVE
|
