| NAME |
AZITHROMYCIN DIHYDRATE 2.5GM/VIL INJ |
| VA GENERIC NAME |
AZITHROMYCIN |
| DOSAGE FORM |
INJ,PWDR |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
2.5 |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2019-02-19 00:00:00 |
| UNITS |
GM/VIAL |
| NATIONAL FORMULARY NAME |
AZITHROMYCIN INJ,PWDR |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
AZITHROMYCIN DIHYDRATE 2.5GM/VIL INJ |
| VA PRODUCT IDENTIFIER |
A1355 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4026091 |
| EFFECTIVE DATE/TIME |
-
- 2007-05-23 00:00:00
- STATUS: ACTIVE
-
- 2019-02-19 00:00:00
- STATUS: INACTIVE
|
