PROSTASCINT KIT (CAPROMAB PENDETIDE) (12877)    VA PRODUCT (50.68)

Name Value
NAME PROSTASCINT KIT (CAPROMAB PENDETIDE)
VA GENERIC NAME INDIUM In 111
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2018-10-15 00:00:00
DSS NUMBER 1
NATIONAL FORMULARY NAME INDIUM IN 111 INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME PROSTASCINT KIT (CAPROMAB PENDETIDE)
VA PRODUCT IDENTIFIER P0508
TRANSMIT TO CMOP NO
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4013242
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2018-10-15 00:00:00
    STATUS:   INACTIVE