| NAME |
FLUCICLOVINE F18 (9-221 MCI/ML) INJ |
| VA GENERIC NAME |
FLUCICLOVINE |
| DOSAGE FORM |
INJ,SOLN |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| NATIONAL FORMULARY NAME |
FLUCICLOVINE INJ,SOLN |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 0
- COPAY EFFECTIVE DATE: 2020-02-19 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
FLUCICLOVINE F18 (9-221 MCI/ML) INJ |
| VA PRODUCT IDENTIFIER |
F0693 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
VI |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039165 |
| EFFECTIVE DATE/TIME |
-
- 2020-02-19 00:00:00
- STATUS: ACTIVE
|
