INFLUENZA TRIVALENT SPLIT VIRUS VACCINE '95-'96,VIAL,5ML (1418)    VA PRODUCT (50.68)

Name Value
NAME INFLUENZA TRIVALENT SPLIT VIRUS VACCINE '95-'96,VIAL,5ML
VA GENERIC NAME INFLUENZA
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2002-10-30 00:00:00
DSS NUMBER 4
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 SPLIT VIRUS '95-'96 VIL 5ML
VA PRODUCT IDENTIFIER I0216
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4002018
EFFECTIVE DATE/TIME
  • 2002-10-30 00:00:00
    STATUS:   INACTIVE
  • 2005-12-08 00:00:00
    STATUS:   INACTIVE