CARBOPROST 250MCG/TROMETHAMINE 83MCG/ML INJ (2951) VA PRODUCT (50.68)

Name	Value
NAME	CARBOPROST 250MCG/TROMETHAMINE 83MCG/ML INJ
VA GENERIC NAME	CARBOPROST/TROMETHAMINE
DOSAGE FORM	INJ,SOLN
ACTIVE INGREDIENTS	CARBOPROST STRENGTH: 250 UNITS: MCG/ML TROMETHAMINE STRENGTH: 83 UNITS: MCG/ML
CS FEDERAL SCHEDULE	Unscheduled
SINGLE/MULTI SOURCE PRODUCT	Single source
DSS NUMBER	1
NATIONAL FORMULARY NAME	CARBOPROST/TROMETHAMINE INJ,SOLN
CREATE DEFAULT POSSIBLE DOSAGE	YES
CODING SYSTEM	RxNorm CODE:
COPAY TIER	COPAY TIER LEVEL: 3 COPAY EFFECTIVE DATE: 2017-02-27 00:00:00 COPAY END DATE: 2021-06-16 00:00:00 COPAY TIER LEVEL: 2 COPAY EFFECTIVE DATE: 2021-06-17 00:00:00
PGX ELIGIBLE	NO
PGX SUPPRESSED	NO
VA PRINT NAME	CARBOPROST 250/TROMETHAMINE 83MCG/ML INJ
VA PRODUCT IDENTIFIER	C0762
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	ML
MASTER ENTRY FOR VUID	YES
VUID	4003530
EFFECTIVE DATE/TIME	2005-03-10 00:00:00 STATUS: ACTIVE