| NAME |
MIDAZOLAM HCL 5MG/ML (PF) INJ,SYRINGE |
| VA GENERIC NAME |
MIDAZOLAM |
| DOSAGE FORM |
INJ,SOLN |
| ACTIVE INGREDIENTS |
|
| CS FEDERAL SCHEDULE |
Schedule IV |
| STRENGTH |
5 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2016-05-13 00:00:00 |
| UNITS |
MG/ML |
| NATIONAL FORMULARY NAME |
MIDAZOLAM INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2017-02-27 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
MIDAZOLAM HCL 5MG/ML (PF) INJ SYRINGE |
| VA PRODUCT IDENTIFIER |
M1108 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
SYRINGE |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035134 |
| EFFECTIVE DATE/TIME |
-
- 2015-11-27 00:00:00
- STATUS: ACTIVE
|
