DIPHTHERIA/PERTUSSIS/POLIOVIRUS/TETANUS VACCINE INJ (19774)    VA PRODUCT (50.68)

Name Value
NAME DIPHTHERIA/PERTUSSIS/POLIOVIRUS/TETANUS VACCINE INJ
VA GENERIC NAME DIPHTHERIA/PERTUSSIS/POLIOVIRUS/TETANUS
DOSAGE FORM INJ,SUSP
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME DIPHTHERIA/PERTUSSIS/POLIOVIRUS/TETANUS 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/PERTUSSIS/POLIO/TETANUS INJ
VA PRODUCT IDENTIFIER D0786
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4027704
EFFECTIVE DATE/TIME
  • 2008-08-20 00:00:00
    STATUS:   ACTIVE
  • 2009-01-30 00:00:00
    STATUS:   INACTIVE
  • 2009-02-06 00:00:00
    STATUS:   ACTIVE