ALLERGENIC EXTRACT,COCCIDIOIDES IMMITIS 1.27MCG/0.1ML INJ,1ML (25132) VA PRODUCT (50.68)

Name	Value
NAME	ALLERGENIC EXTRACT,COCCIDIOIDES IMMITIS 1.27MCG/0.1ML INJ,1ML
VA GENERIC NAME	ALLERGENIC EXTRACT,COCCIDIOIDES IMMITIS
DOSAGE FORM	INJ
ACTIVE INGREDIENTS	COCCIDIOIDES IMMITIS ANTIGEN STRENGTH: 1.27 UNITS: MCG/0.1ML
NATIONAL FORMULARY NAME	ALLERGENIC EXTRACT,COCCIDIOIDES IMMITIS INJ
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
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	ALLERG EXT COCCIDIOIDES 1.27MCG/0.1ML
VA PRODUCT IDENTIFIER	A1769
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4033810
EFFECTIVE DATE/TIME	2014-10-28 00:00:00 STATUS: ACTIVE