ZICONOTIDE 100MCG/ML (PF) INJ,INTRATHECAL,2ML (17127)    VA PRODUCT (50.68)

Name Value
NAME ZICONOTIDE 100MCG/ML (PF) INJ,INTRATHECAL,2ML
VA GENERIC NAME ZICONOTIDE
DOSAGE FORM INJ,SOLN
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
INACTIVATION DATE 2008-09-02 00:00:00
UNITS MCG/ML
NATIONAL FORMULARY NAME ZICONOTIDE 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 ZICONOTIDE 100MCG/ML INJ INTRATHECAL 2ML
VA PRODUCT IDENTIFIER Z0063
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4024559
EFFECTIVE DATE/TIME
  • 2006-01-24 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