| NAME |
VANCOMYCIN HCL 250MG/VIL INJ |
| VA GENERIC NAME |
VANCOMYCIN |
| DOSAGE FORM |
INJ |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
250 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| INACTIVATION DATE |
2022-08-15 00:00:00 |
| UNITS |
MG/VIAL |
| NATIONAL FORMULARY NAME |
VANCOMYCIN INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2018-09-14 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
VANCOMYCIN HCL 250MG/VI INJ |
| VA PRODUCT IDENTIFIER |
V0301 |
| TRANSMIT TO CMOP |
YES |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4037819 |
| EFFECTIVE DATE/TIME |
-
- 2018-09-14 00:00:00
- STATUS: ACTIVE
-
- 2022-08-15 00:00:00
- STATUS: INACTIVE
|
