| NAME |
ALLERGENIC EXTRACT, MOLD, BOTRYTIS CINEREA 43,000PNU/ML INJ |
| VA GENERIC NAME |
ALLERGENIC EXTRACT, MOLD, BOTRYTIS CINEREA |
| DOSAGE FORM |
INJ |
| HAZARDOUS TO DISPOSE |
NO |
| ACTIVE INGREDIENTS |
|
| STRENGTH |
43,000 |
| UNITS |
PNU/ML |
| NATIONAL FORMULARY NAME |
ALLERGENIC EXTRACT, MOLD, BOTRYTIS CINEREA INJ |
| CREATE DEFAULT POSSIBLE DOSAGE |
NO |
| POSSIBLE DOSAGES TO CREATE |
No Possible Dosages |
| CODING SYSTEM |
|
| COPAY TIER |
-
- COPAY TIER LEVEL: 2
- COPAY EFFECTIVE DATE: 2020-06-01 00:00:00
|
| PGX ELIGIBLE |
NO |
| PGX SUPPRESSED |
NO |
| VA PRINT NAME |
ALLERG EXT BOTRYTIS CINEREA 43,000PNU/ML |
| VA PRODUCT IDENTIFIER |
A2058 |
| TRANSMIT TO CMOP |
NO |
| VA DISPENSE UNIT |
ML |
| MASTER ENTRY FOR VUID |
YES |
| VUID |
4039407 |
| EFFECTIVE DATE/TIME |
-
- 2020-06-01 00:00:00
- STATUS: ACTIVE
|
