CAPREOMYCIN SO4 1GM/VIL INJ (315)    VA PRODUCT (50.68)

Name Value
NAME CAPREOMYCIN SO4 1GM/VIL INJ
VA GENERIC NAME CAPREOMYCIN
DOSAGE FORM INJ
FORMULARY DESIGNATOR R
ACTIVE INGREDIENTS
NATIONAL FORMULARY INDICATOR YES
CS FEDERAL SCHEDULE Unscheduled
STRENGTH 1
SINGLE/MULTI SOURCE PRODUCT Single source
UNITS GM/VIAL
DSS NUMBER 1
NATIONAL FORMULARY NAME CAPREOMYCIN INJ
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   3
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
    COPAY END DATE:   2023-03-29 00:00:00
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2023-03-30 00:00:00
VA PRINT NAME CAPREOMYCIN SO4 1GM/VIL INJ
VA PRODUCT IDENTIFIER C2059
TRANSMIT TO CMOP NO
VA DISPENSE UNIT VI
MASTER ENTRY FOR VUID YES
VUID 4000937
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE