INFLUENZA VACCINE,QUADRIVALENT RECOMBINANT (PF),SYRINGE,0.5ML (28869)    VA PRODUCT (50.68)

Name Value
NAME INFLUENZA VACCINE,QUADRIVALENT RECOMBINANT (PF),SYRINGE,0.5ML
VA GENERIC NAME INFLUENZA
DOSAGE FORM INJ
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME INFLUENZA INJ
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE 1x Possible Dosage
PACKAGE Both Inpatient and Outpatient
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2018-10-30 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INFLUENZA VAC,QUAD RECOMBINANT(PF) 0.5ML
VA PRODUCT IDENTIFIER I0655
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4037947
EFFECTIVE DATE/TIME
  • 2018-10-30 00:00:00
    STATUS:   ACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE
  • 2021-01-15 00:00:00
    STATUS:   INACTIVE
  • 2022-07-18 00:00:00
    STATUS:   ACTIVE