BCG (PACIS) 120MG/AMP VACCINE (14703)    VA PRODUCT (50.68)

Name Value
NAME BCG (PACIS) 120MG/AMP VACCINE
VA GENERIC NAME BACILLUS CALMETTE-GUERIN,MONTREAL VACCINE
DOSAGE FORM INJ,LYPHL
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 120
INACTIVATION DATE 2007-09-18 00:00:00
UNITS MG/AMP
NATIONAL FORMULARY NAME BACILLUS CALMETTE-GUERIN,MONTREAL VACCINE INJ,LYPHL
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 BCG (PACIS) 120MG/AMP VACCINE
VA PRODUCT IDENTIFIER B0462
TRANSMIT TO CMOP NO
VA DISPENSE UNIT AMP
MASTER ENTRY FOR VUID YES
VUID 4015067
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-18 00:00:00
    STATUS:   INACTIVE