INFLUENZA VIRUS VACCINE (SPLIT VIRUS),VIL,5ML (1416)    VA PRODUCT (50.68)

Name Value
NAME INFLUENZA VIRUS VACCINE (SPLIT VIRUS),VIL,5ML
VA GENERIC NAME INFLUENZA
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
DSS NUMBER 2
NATIONAL FORMULARY NAME INFLUENZA 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 INFLUENZA VACCINE (SPLIT VIRUS) 5ML VIL
VA PRODUCT IDENTIFIER I0464
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VIL
MASTER ENTRY FOR VUID YES
VUID 4002016
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE