ZICONOTIDE 25MCG/ML (PF) INJ,INTRATHECAL,20ML (17125)    VA PRODUCT (50.68)

Name Value
NAME ZICONOTIDE 25MCG/ML (PF) INJ,INTRATHECAL,20ML
VA GENERIC NAME ZICONOTIDE
DOSAGE FORM INJ,SOLN
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 25
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MCG/ML
NATIONAL FORMULARY NAME ZICONOTIDE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 ZICONOTIDE 25MCG/ML INJ INTRATHECAL 20ML
VA PRODUCT IDENTIFIER Z0061
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4024557
EFFECTIVE DATE/TIME
  • 2006-01-24 00:00:00
    STATUS:   ACTIVE