FIBRIN SEALANT (ARTISS FROZEN) SOLN,TOP,KIT,4ML (28279) VA PRODUCT (50.68)

Name	Value
NAME	FIBRIN SEALANT (ARTISS FROZEN) SOLN,TOP,KIT,4ML
VA GENERIC NAME	FIBRIN SEALANT
DOSAGE FORM	SOLN,TOP
ACTIVE INGREDIENTS	THROMBIN FIBRINOGEN,I-125 CALCIUM CHLORIDE
NATIONAL FORMULARY NAME	FIBRIN SEALANT SOLN,TOP
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: 2018-03-01 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	FIBRIN SEALANT (ARTISS FROZEN) KIT 4ML
VA PRODUCT IDENTIFIER	F0645
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	KIT
MASTER ENTRY FOR VUID	YES
VUID	4037279
EFFECTIVE DATE/TIME	2018-02-05 00:00:00 STATUS: ACTIVE