SULFAMETHOXAZOLE 80MG/TRIMETHOPRIM 16MG/ML INJ (1355)    VA PRODUCT (50.68)

Name Value
NAME SULFAMETHOXAZOLE 80MG/TRIMETHOPRIM 16MG/ML INJ
VA GENERIC NAME SULFAMETHOXAZOLE/TRIMETHOPRIM
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
DSS NUMBER 4
NATIONAL FORMULARY NAME SULFAMETHOXAZOLE/TRIMETHOPRIM INJ,SOLN
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 SULFAMETHOX/TRIMETHOPRIM 80/16MG/ML INJ
VA PRODUCT IDENTIFIER S0956
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4001956
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE