SAMARIUM Sm153 LEXIDRONAM 1850MBq/ML INJ,VIL,2ML (12849)    VA PRODUCT (50.68)

Name Value
NAME SAMARIUM Sm153 LEXIDRONAM 1850MBq/ML INJ,VIL,2ML
VA GENERIC NAME SAMARIUM Sm153
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1850
INACTIVATION DATE 2007-09-25 00:00:00
UNITS MBQ/ML
DSS NUMBER 1
NATIONAL FORMULARY NAME SAMARIUM SM153 INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME SAMARIUM Sm153 LEXIDRONAM 1850MBq/ML INJ
VA PRODUCT IDENTIFIER S0246
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4013214
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-25 00:00:00
    STATUS:   INACTIVE