DAPTOMYCIN 250MG/VIL INJ (16488)    VA PRODUCT (50.68)

Name Value
NAME DAPTOMYCIN 250MG/VIL INJ
VA GENERIC NAME DAPTOMYCIN
DOSAGE FORM INJ,LYPHL
FORMULARY DESIGNATOR R
FORMULARY DESIGNATOR TEXT 
Restricted to ID
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
INACTIVATION DATE 2008-09-02 00:00:00
UNITS MG/VIAL
NATIONAL FORMULARY NAME DAPTOMYCIN 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 DAPTOMYCIN 250MG/VIL INJ
VA PRODUCT IDENTIFIER D0622
TRANSMIT TO CMOP YES
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4016851
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2007-09-28 00:00:00
    STATUS:   INACTIVE
  • 2007-10-10 00:00:00
    STATUS:   ACTIVE
  • 2008-09-02 00:00:00
    STATUS:   INACTIVE