TISSEEL VH TWO COMPONENT FIBRIN SEALANT KIT 1ML (17293) VA PRODUCT (50.68)

Name	Value
NAME	TISSEEL VH TWO COMPONENT FIBRIN SEALANT KIT 1ML
VA GENERIC NAME	TISSEEL
DOSAGE FORM	KIT
ACTIVE INGREDIENTS	THROMBIN STRENGTH: 500 UNITS: UNIT/ML FIBRINOGEN,I-125 STRENGTH: 75-115 UNITS: MG/ML APROTININ STRENGTH: 3000 UNITS: UNT/VIL CALCIUM CHLORIDE STRENGTH: 40 UNITS: MMO
CS FEDERAL SCHEDULE	Unscheduled
INACTIVATION DATE	2012-06-25 00:00:00
NATIONAL FORMULARY NAME	TISSEEL KIT
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	TISSEEL VH 2-COMPONENT KIT 1ML
VA PRODUCT IDENTIFIER	T0597
TRANSMIT TO CMOP	YES
VA DISPENSE UNIT	EA
MASTER ENTRY FOR VUID	YES
VUID	4024725
EFFECTIVE DATE/TIME	2006-01-24 00:00:00 STATUS: ACTIVE 2012-06-25 00:00:00 STATUS: INACTIVE