SUMATRIPTAN SUCCINATE 4MG/0.5ML INJ,KIT (20804)    VA PRODUCT (50.68)

Name Value
NAME SUMATRIPTAN SUCCINATE 4MG/0.5ML INJ,KIT
VA GENERIC NAME SUMATRIPTAN
DOSAGE FORM INJ
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 4
SINGLE/MULTI SOURCE PRODUCT Multisource
UNITS MG/0.5ML
NATIONAL FORMULARY NAME SUMATRIPTAN INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
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 SUMATRIPTAN SUCCINATE 4MG/0.5ML INJ KIT
VA PRODUCT IDENTIFIER S0628
TRANSMIT TO CMOP YES
VA DISPENSE UNIT KIT
MASTER ENTRY FOR VUID YES
VUID 4028870
EFFECTIVE DATE/TIME
  • 2009-08-11 00:00:00
    STATUS:   ACTIVE