| NAME |
MENINGOCOCCAL POLYSACCHARIDE VACCINE (MENOMUNE) INJ,LYPHL |
| VA GENERIC NAME |
MENINGOCOCCAL POLYSACCHARIDE |
| DOSAGE FORM |
INJ,LYPHL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| SINGLE/MULTI SOURCE PRODUCT |
Single source |
| INACTIVATION DATE |
2022-05-17 00:00:00 |
| NATIONAL FORMULARY NAME |
MENINGOCOCCAL POLYSACCHARIDE INJ,LYPHL |
| 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 |
MENINGOCOCCAL POLY (MENOMUNE) INJ |
| VA PRODUCT IDENTIFIER |
M0926 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4030290 |
| EFFECTIVE DATE/TIME |
-
- 2010-12-03 00:00:00
- STATUS: ACTIVE
-
- 2022-05-17 00:00:00
- STATUS: INACTIVE
|
