DIPHTHERIA/HIB/HEP B/PERTUSSIS/POLIO/TETANUS (VAXELIS),VIL,0.5ML (30608)    VA PRODUCT (50.68)

Name Value
NAME DIPHTHERIA/HIB/HEP B/PERTUSSIS/POLIO/TETANUS (VAXELIS),VIL,0.5ML
VA GENERIC NAME DIPHTHERIA/HAEMOPHILUS/HEP B/PERTUSSIS/POLIO/TETANUS
DOSAGE FORM INJ,SUSP
HAZARDOUS TO DISPOSE NO
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
SINGLE/MULTI SOURCE PRODUCT Single source
NATIONAL FORMULARY NAME DIPHTHERIA/HAEMOPHILUS/HEP B/PERTUSSIS/POLIO/TETANUS INJ,SUSP
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2020-12-18 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME VAXELIS VACCINE 0.5ML VIAL
VA PRODUCT IDENTIFIER V0321
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4039920
EFFECTIVE DATE/TIME
  • 2020-12-18 00:00:00
    STATUS:   ACTIVE
  • 2020-12-18 00:00:00
    STATUS:   ACTIVE
  • 2020-12-18 00:00:00
    STATUS:   ACTIVE