FENTANYL 2MCG/BUPIVACAINE 0.125%/ML/NS INJ,BAG,250ML (25992) VA PRODUCT (50.68)

Name	Value
NAME	FENTANYL 2MCG/BUPIVACAINE 0.125%/ML/NS INJ,BAG,250ML
VA GENERIC NAME	BUPIVACAINE/FENTANYL
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	FENTANYL STRENGTH: 2 UNITS: MCG/ML BUPIVACAINE HYDROCHLORIDE STRENGTH: 0.125 UNITS: %
NATIONAL FORMULARY NAME	BUPIVACAINE/FENTANYL INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE	YES
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	FENTANYL 2MCG/BUPIV 0.125%/ML NS 250ML
VA PRODUCT IDENTIFIER	F0574
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	BAG
MASTER ENTRY FOR VUID	YES
VUID	4034768
EFFECTIVE DATE/TIME	2015-08-28 00:00:00 STATUS: ACTIVE