DIPHTHERIA/HIB/HEP B/PERTUSSIS/POLIO/TETANUS (VAXELIS),SYR,0.5ML (30609) VA PRODUCT (50.68)

Name	Value
NAME	DIPHTHERIA/HIB/HEP B/PERTUSSIS/POLIO/TETANUS (VAXELIS),SYR,0.5ML
VA GENERIC NAME	DIPHTHERIA/HAEMOPHILUS/HEP B/PERTUSSIS/POLIO/TETANUS
DOSAGE FORM	INJ,SUSP
HAZARDOUS TO DISPOSE	NO
ACTIVE INGREDIENTS	PERTUSSIS VACCINE,ACELLULAR POLIOVIRUS VACCINE INACTIVATED DIPHTHERIA TOXOID TETANUS TOXOID HAEMOPHILUS B HEPATITIS B VACCINE (RECOMBINANT)
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 SYRINGE
VA PRODUCT IDENTIFIER	V0322
TRANSMIT TO CMOP	NO
VA DISPENSE UNIT	SYR
MASTER ENTRY FOR VUID	YES
VUID	4039923
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