BCG,TICE (BCG VACCINE) 50MG/VIL TB VACCINE (20618)    VA PRODUCT (50.68)

Name Value
NAME BCG,TICE (BCG VACCINE) 50MG/VIL TB VACCINE
VA GENERIC NAME BACILLUS CALMETTE-GUERIN,TICE VACCINE
DOSAGE FORM PWDR,RENST-IRRG
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
FORMULARY DESIGNATOR TEXT 
Restrict to Urology
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 50
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/VIAL
NATIONAL FORMULARY NAME BACILLUS CALMETTE-GUERIN,TICE VACCINE PWDR,RENST-IRRG
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
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 BCG,TICE (BCG VACCINE) 50MG/VIL TB VACC
VA PRODUCT IDENTIFIER B0620
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VIL
MASTER ENTRY FOR VUID YES
VUID 4028643
EFFECTIVE DATE/TIME
  • 2009-06-10 00:00:00
    STATUS:   ACTIVE