LYME DISEASE VACCINE 30MCG/0.5ML INJ (13033)    VA PRODUCT (50.68)

Name Value
NAME LYME DISEASE VACCINE 30MCG/0.5ML INJ
VA GENERIC NAME LYME DISEASE VACCINE
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 30
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2002-04-24 00:00:00
UNITS MCG/0.5ML
NATIONAL FORMULARY NAME LYME DISEASE VACCINE 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 LYME DISEASE VACCINE 30MCG/0.5ML INJ
VA PRODUCT IDENTIFIER L0216
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4013398
EFFECTIVE DATE/TIME
  • 2002-04-24 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE