| NAME |
DIANEAL LOW CALCIUM PERITONEAL DIALYSIS SOLUTION WITH DEXTROSE |
| VA GENERIC NAME |
DEXTROSE/PERITONEAL DIALYSIS SOLUTION |
| DOSAGE FORM |
SOLN,DIALYSIS |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Unscheduled |
| INACTIVATION DATE |
2011-08-24 00:00:00 |
| NATIONAL FORMULARY NAME |
DEXTROSE/PERITONEAL DIALYSIS SOLUTION SOLN,DIALYSIS |
| 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 |
DIANEAL LOW CALCIUM/DEXTROSE 1.5% SOLN |
| VA PRODUCT IDENTIFIER |
D0889 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4030638 |
| EFFECTIVE DATE/TIME |
-
- 2011-05-05 00:00:00
- STATUS: ACTIVE
-
- 2011-08-24 00:00:00
- STATUS: INACTIVE
|
