CEFTRIAXONE NA 250MG/VIL INJ (1695)    VA PRODUCT (50.68)

Name Value
NAME CEFTRIAXONE NA 250MG/VIL INJ
VA GENERIC NAME CEFTRIAXONE
DOSAGE FORM INJ,SOLN
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 250
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/VIAL
DSS NUMBER 1
NATIONAL FORMULARY NAME CEFTRIAXONE INJ,SOLN
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 CEFTRIAXONE NA 250MG/VI INJ
VA PRODUCT IDENTIFIER C0338
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4002281
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE