OMADACYCLINE 100MG/VIAL INJ (28967)    VA PRODUCT (50.68)

Name Value
NAME OMADACYCLINE 100MG/VIAL INJ
VA GENERIC NAME OMADACYCLINE
DOSAGE FORM INJ,LYPHL
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 100
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/VIAL
NATIONAL FORMULARY NAME OMADACYCLINE INJ,LYPHL
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2018-12-20 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME OMADACYCLINE 100MG/VIAL INJ
VA PRODUCT IDENTIFIER O0406
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4038064
EFFECTIVE DATE/TIME
  • 2018-12-20 00:00:00
    STATUS:   ACTIVE