DEXMEDETOMIDINE HCL 100MCG/ML INJ (14377)    VA PRODUCT (50.68)

Name Value
NAME DEXMEDETOMIDINE HCL 100MCG/ML INJ
VA GENERIC NAME DEXMEDETOMIDINE
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MCG/ML
NATIONAL FORMULARY NAME DEXMEDETOMIDINE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 DEXMEDETOMIDINE HCL 100MCG/ML INJ
VA PRODUCT IDENTIFIER D0517
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4014741
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE