GLOBULIN,IMMUNE (SQ) 200MG/ML INJ,SYRINGE,20ML (30508)    VA PRODUCT (50.68)

Name Value
NAME GLOBULIN,IMMUNE (SQ) 200MG/ML INJ,SYRINGE,20ML
VA GENERIC NAME GLOBULIN,IMMUNE
DOSAGE FORM INJ,SOLN
HAZARDOUS TO DISPOSE NO
FORMULARY DESIGNATOR PA-F
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 200
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS MG/ML
NATIONAL FORMULARY NAME GLOBULIN,IMMUNE 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:   2020-11-02 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME GLOBULIN,IMMUNE (SQ) 200MG/ML SYR 20ML
VA PRODUCT IDENTIFIER G0496
TRANSMIT TO CMOP NO
VA DISPENSE UNIT SYR
MASTER ENTRY FOR VUID YES
VUID 4039807
EFFECTIVE DATE/TIME
  • 2020-11-02 00:00:00
    STATUS:   ACTIVE
  • 2020-11-02 00:00:00
    STATUS:   ACTIVE
  • 2020-11-02 00:00:00
    STATUS:   ACTIVE