INFLUENZA VACCINE,TRIVALENT,HIGH-DOSE(PF),SYRINGE,0.5ML (24057)    VA PRODUCT (50.68)

Name Value
NAME INFLUENZA VACCINE,TRIVALENT,HIGH-DOSE(PF),SYRINGE,0.5ML
VA GENERIC NAME INFLUENZA
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
INACTIVATION DATE 2021-01-15 00:00:00
NATIONAL FORMULARY NAME INFLUENZA INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
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 INFLUENZA VAC,TRI HIGH-DOSE SYR 0.5ML
VA PRODUCT IDENTIFIER I0551
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4032584
EFFECTIVE DATE/TIME
  • 2013-07-31 00:00:00
    STATUS:   ACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE