| NAME |
VANCOMYCIN HCL 1.25GM/VIAL INJ |
| VA GENERIC NAME |
VANCOMYCIN |
| DOSAGE FORM |
INJ |
| HAZARDOUS TO DISPOSE |
NO |
| FORMULARY DESIGNATOR |
R |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY INDICATOR |
YES |
| CS FEDERAL SCHEDULE |
Unscheduled |
| STRENGTH |
1.25 |
| SINGLE/MULTI SOURCE PRODUCT |
Multisource |
| UNITS |
GM/VIAL |
| NATIONAL FORMULARY NAME |
VANCOMYCIN INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
YES |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2019-01-10 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
VANCOMYCIN HCL 1.25GM/VIAL INJ |
| VA PRODUCT IDENTIFIER |
V0303 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038098 |
| EFFECTIVE DATE/TIME |
-
- 2019-01-10 00:00:00
- STATUS: ACTIVE
|
