| NAME |
ROTAVIRUS PENTAVALENT VACCINE LIVE SUSP,ORAL,2ML |
| VA GENERIC NAME |
ROTAVIRUS |
| DOSAGE FORM |
SUSP,ORAL |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
NO |
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2017-04-14 00:00:00 |
| NATIONAL FORMULARY NAME |
ROTAVIRUS SUSP,ORAL |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ROTAVIRUS PENTAVALENT ORAL SUSP 2ML |
| VA PRODUCT IDENTIFIER |
R0186 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
TUBE |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4024990 |
| EFFECTIVE DATE/TIME |
-
- 2006-03-28 00:00:00
- STATUS: ACTIVE
|
