INDIUM IN -111 PENTETREOTIDE 111MBQ/ML INJ,SOLN (29162)    VA PRODUCT (50.68)

Name Value
NAME INDIUM IN -111 PENTETREOTIDE 111MBQ/ML INJ,SOLN
VA GENERIC NAME INDIUM In 111
DOSAGE FORM INJ,SOLN
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
STRENGTH 111
UNITS MBQ/ML
NATIONAL FORMULARY NAME INDIUM IN 111 INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE NO
POSSIBLE DOSAGES TO CREATE No Possible Dosages
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2019-04-05 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME INDIUM-111 PENTETREOTIDE 111MBQ/ML INJ
VA PRODUCT IDENTIFIER I0663
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4038292
EFFECTIVE DATE/TIME
  • 2019-04-05 00:00:00
    STATUS:   ACTIVE