| NAME |
SODIUM BENZOATE 10%/SODIUM PHENYLACETATE 10% INJ,CONC |
| VA GENERIC NAME |
SODIUM BENZOATE/SODIUM PHENYLACETATE |
| DOSAGE FORM |
INJ,CONC |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
SODIUM BENZOATE/SODIUM PHENYLACETATE INJ,CONC |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| 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 |
NA BENZOATE/NA PHENYLACETATE 10%CONC INJ |
| VA PRODUCT IDENTIFIER |
N0772 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4035830 |
| EFFECTIVE DATE/TIME |
-
- 2016-06-23 00:00:00
- STATUS: ACTIVE
|
