FLUDEOXYGLUCOSE F 18 (20-500 MCI/ML) INJ (29766)    VA PRODUCT (50.68)

Name Value
NAME FLUDEOXYGLUCOSE F 18 (20-500 MCI/ML) INJ
VA GENERIC NAME FLUDEOXYGLUCOSE F 18
DOSAGE FORM INJ,SOLN
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
NATIONAL FORMULARY NAME FLUDEOXYGLUCOSE F 18 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:   2019-11-29 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME FLUDEOXYGLUCOSE F 18 (20-500 MCI/ML) INJ
VA PRODUCT IDENTIFIER F0689
TRANSMIT TO CMOP NO
VA DISPENSE UNIT ML
MASTER ENTRY FOR VUID YES
VUID 4038973
EFFECTIVE DATE/TIME
  • 2019-12-02 00:00:00
    STATUS:   ACTIVE