| NAME |
REBETRON 1200/MDV PKT (1236-01) |
| VA GENERIC NAME |
INTERFERON ALFA-2B/RIBAVIRIN |
| DOSAGE FORM |
CAP/INJ |
| HAZARDOUS TO DISPOSE |
NO |
| DOT SHIPPING CODE |
|
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2007-10-01 00:00:00 |
| DSS NUMBER |
5 |
| NATIONAL FORMULARY NAME |
INTERFERON ALFA-2B/RIBAVIRIN CAP/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 |
REBETRON 1200/MDV PKT (1236-01) |
| VA PRODUCT IDENTIFIER |
R0085 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
PKT |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4013235 |
| EFFECTIVE DATE/TIME |
-
- 2005-03-10 00:00:00
- STATUS: ACTIVE
-
- 2007-10-01 00:00:00
- STATUS: INACTIVE
|
