HAEMOPHILUS B 7.5/MENINGOCOCCAL 125MCG/0.5ML (PEDVAX HIB) INJ (26331) VA PRODUCT (50.68)

Name	Value
NAME	HAEMOPHILUS B 7.5/MENINGOCOCCAL 125MCG/0.5ML (PEDVAX HIB) INJ
VA GENERIC NAME	HAEMOPHILUS B/NEISSERIA MENINGITIDIS
DOSAGE FORM	INJ
ACTIVE INGREDIENTS	NEISSERIA MENINGITIDIS OMPC STRENGTH: 125 UNITS: MCG/0.5ML HAEMOPHILUS B STRENGTH: 7.5 UNITS: MCG/0.5ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
NATIONAL FORMULARY NAME	HAEMOPHILUS B/NEISSERIA MENINGITIDIS INJ
CREATE DEFAULT POSSIBLE DOSAGE	NO
POSSIBLE DOSAGES TO CREATE	No Possible Dosages
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	HAEMOPHILIUS/MENING VAC (PEDVAX HIB) INJ
VA PRODUCT IDENTIFIER	H0686
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	VI
MASTER ENTRY FOR VUID	YES
VUID	4035140
EFFECTIVE DATE/TIME	2015-12-08 00:00:00 STATUS: ACTIVE