| NAME |
INFLUENZA VACCINE,TRIVALENT (PF/LATEX-FREE),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 |
| NATIONAL FORMULARY NAME |
INFLUENZA INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
1x Possible Dosage |
| PACKAGE |
Both Inpatient and Outpatient |
| 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 |
INFLUENZA VAC,TRI (PF/LATEX-FREE) SYR |
| VA PRODUCT IDENTIFIER |
I0580 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYR |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4033452 |
| EFFECTIVE DATE/TIME |
-
- 2014-06-24 00:00:00
- STATUS: ACTIVE
|
