| NAME |
GALLIUM DOTATATE (GA-68) 40MCG/VIL INJ |
| VA GENERIC NAME |
GALLIUM DOTATATE,GA-68 |
| DOSAGE FORM |
INJ,LYPHL |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| STRENGTH |
40 |
| UNITS |
MCG/VIL |
| NATIONAL FORMULARY NAME |
GALLIUM DOTATATE,GA-68 INJ,LYPHL |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2019-03-21 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
GALLIUM DOTATATE (GA-68) 40MCG/VIL INJ |
| VA PRODUCT IDENTIFIER |
G0475 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4038252 |
| EFFECTIVE DATE/TIME |
-
- 2019-03-22 00:00:00
- STATUS: ACTIVE
|
