DIPHTHERIA TOXOID/MENINGOCOCCAL POLYSACCHARIDE INJ VACCINE (17345)    VA PRODUCT (50.68)

Name Value
NAME DIPHTHERIA TOXOID/MENINGOCOCCAL POLYSACCHARIDE INJ VACCINE
VA GENERIC NAME DIPHTHERIA TOXOID/MENINGOCOCCAL
DOSAGE FORM INJ,SUSP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2012-01-20 00:00:00
NATIONAL FORMULARY NAME DIPHTHERIA TOXOID/MENINGOCOCCAL INJ,SUSP
CREATE DEFAULT POSSIBLE DOSAGE YES
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 DIPHTHERIA TOX/MENINGOCOCCAL VACCINE
VA PRODUCT IDENTIFIER D0667
TRANSMIT TO CMOP YES
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4024777
EFFECTIVE DATE/TIME
  • 2006-01-24 00:00:00
    STATUS:   ACTIVE
  • 2012-01-20 00:00:00
    STATUS:   INACTIVE
  • 2012-01-20 00:00:00
    STATUS:   INACTIVE